Human hypercholesterolemia causal gene and use thereof

ABSTRACT

The present invention discloses the identification of a human hypercholesterolemia causal gene, which can be used for the diagnosis, prevention and treatment of hypercholesterolemia, more particularly familial hypercholesterolemia, as well as for the screening of therapeutically active drugs. The invention more specifically disclosed that mutations in the PCSK9 gene encoding NARC-1 causes autosomal dominant hypercholesterolemia and represent novel targets for therapeutic intervention. The invention can be used in the diagnosis of predisposition to, detection, prevention and/or treatment of coronary heart disease and, cholesterol, lipid and lipoprotein metabolism disorders, including familial hypercholesterolemia, atherogenic dyslipidemia, atherosclerosis, cardiovascular diseases.

INTRODUCTION

[0001] The present invention relates generally to the fields of genetics and medicine. The present invention more particularly discloses the identification of a human hypercholesterolemia causal gene, which can be used for the diagnosis, prevention and treatment of hypercholesterolemia, and more particularly familial hypercholesterolemia ADH, as well as for the screening of therapeutically active drugs. The invention more specifically discloses that mutations in the PCSK9 gene encoding NARC-1 cause autosomal dominant hypercholesterolemia (ADH) and represent novel targets for therapeutic intervention. The invention can be used in the diagnosis of predisposition to, detection, prevention and/or treatment of cholesterol and lipoprotein metabolism disorders, including familial hypercholesterolemia, atherogenic dyslipidemia, atherosclerosis, and more generally cardiovascular diseases (CVD).

BACKGROUND

[0002] Atherosclerosis is a disease of the arteries responsible for coronary heart disease (CVD) that underlies most deaths in industrialized countries (Lusis, 2000). Several risk factors for CHD have now been well established: dyslipidemias, hypertension, diabetes, smoking, poor diet, inactivity and stress. The most clinically relevant and common dyslipidemias are characterized by an increase in beta-lipoproteins (VLDL and LDL particles) with hypercholesterolemia in the absence or presence of hypertriglyceridemia (Fredrickson et al, 1967). An isolated elevation of LDL cholesterol is one of the most common risk factors for CVD. Twin studies (Austin et al, 1987) and family data (Perusse, 1989; Rice et al, 1991) have shown the importance of genetic factors in the development of the disease, particularly when its complications occur early in life. Mendelian forms of hypercholesterolemia have been identified: at first the autosomal dominant form (ADH) (Khachadurian, 1964) and later the autosomal recessive form (ARH), initially described as “pseudohomozygous type II hyperlipoproteinemia” (Morganroth et al, 1967).

[0003] ADH is an heterogeneous genetic disorder. Its most frequent and archetypal form is Familial Hypercholesterolemia (FH) with a frequency of 1 in 500 for heterozygotes and 1 per million for homozygotes (Goldstein et al, 1973). The disease is co-dominant with homozygotes being affected earlier and more severely than heterozygotes. FH is caused by mutations in the gene that encodes the LDL receptor (Goldstein & Brown, 1978) (LDLR at 19p13.1-p13.3) (MIN 143890). It is characterized by a selective increase of LDL cholesterol levels in plasma giving rise to tendon and skin xanthomas, arcus corneae and cardiovascular deposits leading to progressive and premature atherosclerosis, CHD and mortality (occurring before 55 years). The second form of ADH is Familial Defective apo B-100 (FDB) caused by mutations in the apolipoprotein B gene (APOB at 2p23-p24), encoding the ligand of the LDL receptor (Inneraty et al, 1987) (MIN 144010). The existence of a greater level of genetic heterogeneity in ADH (Saint-Jore et al, 2000) has been reported and the implication of a third locus named HCHOLA3 (formerly FH3) has been detected and mapped at 1p34.1-p32 in a French family (Varret et al, 1999) (MIM 603776). These results were confirmed by Hunt et al. in a large Utah kindred (Hunt et al, 2000).

[0004] There is a strong need of identifying genes involved in hypercholesterolemia, more particularly in ADH, in order to understand the mechanisms leading to these disorders and to develop improved diagnosis and therapeutic treatment.

SUMMARY OF THE INVENTION

[0005] The inventors have shown that mutations in the PCSK9 gene encoding NARC-1 cause autosomal dominant hypercholesterolemia. They have demonstrated that the NARC-1 protein contributes to cholesterol homeostasis. The invention thus discloses novel targets for diagnosis and therapeutic intervention for hypercholesterolemia, more particularly ADH, CVD, lipid and lipoprotein metabolism disorders, atherogenic dyslipidemia, atherosclerosis, and cardiovascular diseases.

[0006] In a first aspect, the invention concerns a PCSK9 gene or a fragment thereof comprising an alteration, said alteration reducing, modifying or abolishing the activity of NARC-1. Preferably, said alteration is a nucleotide substitution. More preferably, said nucleotide substitution leads to an amino acid change in NARC-1 protein. Preferably, said amino acid change is located at or near the catalytic site or a zymogen processing of the NARC-1 protein and decreases the catalytic activity or autocatalytic cleavage of said protein or functional domain, respectively. Alternatively, the alteration affects the splicing of NARC-1 mRNA.

[0007] The invention also concerns a corresponding NARC-1 protein or a fragment thereof comprising an alteration, said alteration reducing, modifying or abolishing the activity of NARC-1. Preferably, the alteration is located at the catalytic site of the NARC-1 protein and decreases its catalytic activity or at a zymogen processing site of NARC-1 and decreases its autocatalytic cleavage. In an other preferred embodiment, the alteration is located near the catalytic site of the NARC-1 protein and decreases its catalytic activity or near the zymogen processing sites of NARC-1 and decreases its autocatalytic cleavage. An aspect of the present invention concerns a method of genotyping in a subject a polymorphism of the PCSK9 gene, preferably a polymorphism disclosed in Table 2. The invention also concerns a method of associating one or several polymorphism(s) of the PCSK9 gene, preferably one or several polymorphism(s) disclosed in Table 2 to a disease or a disorder.

[0008] An other aspect of this invention relates to a method of detecting the presence of or predisposition to hypercholesterolemia, more particularly ADH, or lipid and lipoprotein metabolism disorders in a subject, the method comprising detecting in a sample from the subject the presence of an alteration in the PCSK9 gene or in the NARC-1 protein, the presence of said alteration being indicative of the presence or predisposition to hypercholesterolemia, more particularly ADH, or lipid and lipoprotein metabolism disorders. In a most preferred embodiment, said alteration reduces, modifies, or abolishes the activity of NARC-1. Optionally, the method further comprises detecting the presence of an alteration in the LDL receptor and/or the apolipoprotein B in said sample.

[0009] The invention also relates to a diagnostic kit comprising primers, probes and/or antibodies for detecting in a sample from a subject the presence of an alteration in the PCSK9 gene or in the NARC-1 protein, in the NARC-1 RNA or polypeptide expression, and/or in NARC-1 activity. Optionally, said diagnostic kit further comprises reagents for detecting in a sample from a subject the presence of an alteration in the LDL receptor and/or the apolipoprotein B.

[0010] A further aspect of the invention relates to the use of a functional NARC-1, preferably a wild-type NARC-1 protein or a nucleic acid encoding the same, in the manufacture of a pharmaceutical composition for treating or preventing hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject. The invention also relates to the use of a biologically active compound which modulates NARC-1 activity, in the manufacture of a pharmaceutical composition for treating or preventing hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject. The invention also relates to a method for treating or preventing hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject comprising administering to said subject a functional NARC-1, preferably a wild-type NARC-1 protein or a nucleic acid encoding the same. The invention further relates to a method for treating or preventing hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject comprising administering to said subject a biologically active compound which modulates NARC-1 activity.

[0011] An additional aspect of this invention relates to methods of selecting biologically active compounds that modulate the activity of NARC-1 protein, typically of an altered NARC-1 polypeptide. The compounds are more particularly suitable for treating hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders.

LEGEND TO FIGURES

[0012]FIG. 1: Family HC92 Pedigree and Genetic Analysis with Markers Spanning the 1p34.1-p32 Region

[0013] Affected subjects present with a history of tendon xanthomas (HC92-II-7 and III-3), CHD, early myocardial infarction (HC92-II-2 and II-6) and stroke (HC92-II-4). The affected allele is represented by the filled bars. Age (in years) at lipid measurement, total and LDL cholesterol (in g/L; untreated values for affected members) are given.

[0014]FIG. 2: Genetic Analysis of Family HC2

[0015] Pedigree of the HC2 family is shown. Half-blackened symbols indicate affected members, unblackened symbols indicate unaffected members, and hatched symbols indicate members with an unknown phenotypic status. The haplotype in brackets of subject HC2-I-1 was unequivocally deduced. Selected markers spanning the 1p34.1-p32 region are displayed to the left of the pedigrees. The affected allele is represented by the filled bars. Age (in years) at lipid measurement, total and LDL cholesterol (in g/L; untreated values for affected members) are given.

[0016]FIG. 3: Genetic Analysis and Mutation Detection in Families HC92 and HC60

[0017] a, Results of LINKMAP analyses in the HC92 family indicating a maximum lod score for D1S2742 at θ=0. PCSK9 maps 1.2 Mb to this marker. b, Mutation in family HC92. The proband (HC92-II-7) is heterozygous for a T→A substitution in exon 2 at nucleotide 625 (S127R). c, Family pedigree and genetic analysis of family HC60. d, Sequence analysis in family HC60. The proband (HC60-II-2) is heterozygous for a T→C substitution in exon 4 at nucleotide 890 predicting a substitution at 216 of leucine for the conserved phenylalanine (F216L).

[0018]FIG. 4: Mutations Study

[0019] a, Segregation of the S127R mutation in part of family HC2. The T→A substitution at nucleotide 625 creates a new recognition cleavage site for restriction digestion by MnlI (represented by *). After electrophoretic migration on a 2% agarose gel, fragments of 208, 203 and 60 bp were distinguished in the normal allele, while fragments of 208, 143 and 60 bp appeared in the mutated alleles (the 203 bp normal fragment was divided in fragments of 143 and 60 bp and the two 60 bp fragments generated comigrated). The proband (HC2-II-9) and one of her children (HC2-II-10) were observed to be heterozygous for the S127R mutation (as indicated by both the 203 and 143 bp bands).

[0020] b, The amino acid sequence alignment for NARC-1 shows conservation of the serine at codon 127 between human, mouse and rat. DNA sequences of the normal and mutant genes are shown above and below the amino acid sequences, respectively.

[0021] c, The amino acid sequence alignment for NARC-1 shows conservation of the phenylalanine at codon 216 between human, mouse and rat. DNA sequences of the normal and mutant genes are shown above and below the amino acid sequences, respectively.

DETAILED DESCRIPTION OF THE INVENTION

[0022] Definition

[0023] The PCSK9 gene (or NARC-1 gene) encodes the NARC-1 protein or polypeptide. The NARC-1 protein is translated as a pre-protein which is autocatalytically processed into a mature NARC-1 protein. The sequence of the NARC-1 gene has been described in patent applications WO 01/57081 and WO 02/14358, and partly characterized in Seidah et al (2003). The residues of the NARC-1 catalytic site consist in Asp-186, Ser-188, His-226, Asn-317 and Ser-386. NARC-1 presents two zymogen processing sites : a first one comprising residues 78 to 82 and having a primary cleavage site located at position 82; a second one comprising residues 138 to 142 and having a putative secondary cleavage site located at position 142 . The biological function of NARC-1 and the implication of this protein in hypercholesterolemia and lipid and lipoprotein metabolism disorders were unknown.

[0024] Within the context of this invention, the PCSK9 gene locus designates all PCSK9 sequences or products in a cell or organism, including PCSK9 coding sequences, PCSK9 non-coding sequences (e.g., introns, 5′ and 3′ UTR), PCSK9 regulatory sequences controlling transcription and/or translation (e.g., promoter, enhancer, terminator, etc.), as well as all corresponding expression products, such as PCSK9 RNAs (e.g. mRNA) and NARC-1 polypeptides (e.g., a pre-protein and a mature protein).

[0025] The term “gene” shall be construed to include any type of coding nucleic acid, including genomic DNA, complementary DNA (cDNA), synthetic or semi-synthetic DNA, as well as any form of corresponding RNA. The term gene particularly includes recombinant nucleic acids encoding NARC-1, i.e., any non naturally occurring nucleic acid molecule created artificially, e.g., by assembling, cutting, ligating or amplifying sequences. A PCSK9 gene is typically double-stranded, although other forms may be contemplated, such as single-stranded. PCSK9 genes may be obtained from various sources and according to various techniques known in the art, such as by screening DNA libraries or by amplification from various natural sources. Recombinant nucleic acids may be prepared by conventional techniques, including chemical synthesis, genetic engineering, enzymatic techniques, or a combination thereof A particular example of a PCSK9 gene comprises SEQ ID NO: 1.

[0026] The indicated positions in a PCSK9 gene and a NARC-1 protein refer to the positions in the sequences of SEQ ID No 1 and SEQ ID No 2, respectively.

[0027] The term “hybridize under stringent conditions” means that two nucleic acid fragments are capable of hybridization to one another under standard hybridization conditions described in Sambrook et al., Molecular Cloning: A Laboratory Manual (1989) Cold Spring Harbor Laboratory Press, New York, USA. More specifically, “stringent conditions” as used herein refer to hybridization at 65° C. in a hybridization buffer consisting of 250 mmol/l sodium phosphate buffer pH 7.2, 7% (w/v) SDS, 1% (w/v) BSA, 1 mmol/l EDTA and 0.1 mg/ml single-stranded salmon sperm DNA.

[0028] GENE & PROTEIN

[0029] The invention concerns an isolated or recombinant PCSK9 gene comprising an alteration causing hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders.

[0030] The altered PCSK9 gene comprises an alteration leading to a decrease or a complete loss of NARC-1 activity, or to a new NARC-1 activity. This decrease, loss, or new activity can be due to the decrease or loss of the activity of NARC-1 enzyme, to the decrease of NARC-1 stability (either at the stage of nucleic acid or proprotein or protein), to a change of substrate specificity of NARC-1 or to the disturbance or impediment of the NARC-1 polymerization. This decrease or loss of NARC-1 activity can be due to a NARC-1 alteration leading to a decrease or loss of the pro-NARC-1 maturation, either at the first cleavage or the second one or both. The alteration can also affect the catalytic activity by modifying the catalytic site of NARC-1 or its substrate recognition site. Furthermore, the alteration can affect the splicing of the NARC-1 MRNA, leading to an alternative splicing product.

[0031] The invention concerns an isolated or recombinant PCSK9 gene or fragment thereof comprising an alteration, wherein said alteration reduces, modifies or abolishes the activity of NARC-1. Preferably, said alteration is a nucleotide substitution. More preferably, said nucleotide substitution leads to an amino acid change in NARC-1 protein. Preferably, said amino acid change is located at (e.g., within) the catalytic site of the NARC-1 protein and decreases its catalytic activity, or is located at a zymogen processing site of NARC-1 and decreases its autocatalytic cleavage. In an other preferred embodiment, said amino acid change is located near the catalytic site of the NARC-1 protein and decreases its catalytic activity or near the zymogen processing sites of NARC-1 and decreases its autocatalytic cleavage. Alternatively, the alteration may affect the splicing of NARC-1 mRNA. More specifically, said alteration can be is a substitution at nucleotide 625 and/or 890 of SEQ ID No 1. More preferably, said alteration is selected from the group consisting of a T→A substitution at nucleotide 625 of SEQ ID No 1, a T→C substitution at nucleotide 890 of SEQ ID No 1 and a combination thereof. In a further embodiment, said alteration is selected from the group consisting of a substitution at nucleotides 476-478 of SEQ ID No 1, a substitution at nucleotides 482-484 of SEQ ID No 1, a substitution at nucleotides 488-490 of SEQ ID No 1, a substitution at nucleotides 485-490 of SEQ ID No 1, a substitution at nucleotides 548-553 of SEQ ID No 1, a substitution at nucleotides 479-481, 491-493 and 578-580 of SEQ ID No 1, a substitution at nucleotides 620-622 of SEQ ID No 1, a substitution at nucleotides 656-658 of SEQ ID No 1, a substitution at nucleotides 671-673 of SEQ ID No 1, a substitution at nucleotides 920-922 of SEQ ID No 1, and a substitution at nucleotides 1193-1195 of SEQ ID No 1.

[0032] The invention also concerns an isolated or recombinant PCSK9 gene or fragment thereof comprising at least one alteration, wherein said alteration is selected from the group consisting of the polymorphisms listed in Table 2 and in Table 4.

[0033] The invention relates to an isolated or purified NARC-1 protein or a fragment thereof comprising an alteration, wherein said alteration reduces, modifies or abolishes the activity of NARC-1. Preferably, the alteration is located at the catalytic site of the NARC-1 protein and decreases its catalytic activity or at a zymogen processing site of NARC-1 and decreases its autocatalytic cleavage. In an other preferred embodiment, the alteration is located near the catalytic site of the NARC-1 protein and decreases its catalytic activity or near the zymogen processing sites of NARC-1 and decreases its autocatalytic cleavage. More preferably, said alteration can be selected from the group consisting of a substitution of the residue Serine at position 127, a substitution of the residue Phenylalanine at position 216 and a combination thereof. Still more preferably, said alteration is selected from the group consisting of a substitution of the residue Serine at position 127 of SEQ ID No 2 by an Arginine (S127R), a substitution of the residue Phenylalanine at position 216 of SEQ ID No 2 by a Leucine (F216L) and a combination thereof. In a further embodiment, said alteration is selected from the group consisting of a substitution of the residue Tyrosine at position 78 of SEQ ID No 2, a substitution of the residue Valine at position 80 of SEQ ID No 2, a substitution of the residue Leucine at position 82 of SEQ ID No 2, a substitution of the residues Valine at positions 79, 80 and 81 of SEQ ID No 2, a substitution of the residues Alanines at positions 102 and 103 of SEQ ID No 2, a substitution of the residues Valine at position 79, Lysine at position 83, and Leucine at position 112 of SEQ ID No 2, a substitution of the residue Methionine at position 126 of SEQ ID No 2, a substitution of the residue Proline at position 138 of SEQ ID No 2, a substitution of the residue Isoleucine at position 143 of SEQ ID No 2, a substitution of the residue Histidine at position 226 of SEQ ID No 2, and a substitution of the residue Asparagine at position 317 of SEQ ID No 2. Preferably, said alteration is selected from the group consisting of a substitution of the residue Tyrosine at position 78 of SEQ ID No 2 by an Alanine (Y78A), a substitution of the residue Valine at position 80 of SEQ ID No 2 by an Alanine or a Leucine (V80A or V80L), a substitution of the residue Leucine at position 82 of SEQ ID No 2 by an Alanine, a Valine or a Proline (L82A, L82V or L82P), a substitution of the residues Valine at positions 79, 80 and 81 of SEQ ID No 2 by an Arginine, an Arginine and a Leucine, respectively (V79R, V80R and V81L), a substitution of the residues Alanines at positions 102 and 103 of SEQ ID No 2 by Arginines (A102R and A103R), a substitution of the residues Valine at position 79, Lysine at position 83, and Leucine at position 112 of SEQ ID No 2 by an Isoleucine, a Methionine, a Proline, respectively (V79I, K83M and L112P), a substitution of the residue Methionine at position 126 of SEQ ID No 2 by an Alanine (M126A), a substitution of the residue Proline at position 138 of SEQ ID No 2 by a Tyrosine (P138Y), a substitution of the residue Isoleucine at position 143 of SEQ ID No 2 by a Proline (I143P), a substitution of the residue Histidine at position 226 of SEQ ID No 2 by an Alanine (H226A), and a substitution of the residue Asparagine at position 317 of SEQ ID No 2 by an Alanine (N317A). Alternatively, said alteration can be selected from the group consisting of a substitution of the residue Arginine at position 218 of SEQ ID No 2, a substitution of the residue Arginine at position 237 of SEQ ID No 2 and a combination thereof, more preferably a substitution of the residue Arginine at position 218 of SEQ ID No 2 by a Serine (R218S) or a substitution of the residue Arginine at position 237 of SEQ ID No 2 by a Tryptophane (R237W) or a combination thereof.

[0034] The invention also relates to an isolated or purified NARC-1 protein or a fragment thereof comprising an alteration, wherein said alteration is selected from the group consisting of an insertion of a residue Leucine at position 15 of SEQ ID No 2, a substitution of the residue Arginine at position 46 of SEQ ID No 2 by a Leucine (R46L), a substitution of the residue Alanine at position 53 of SEQ ID No 2 by a Valine (A53V), a substitution of the residue Isoleucine at position 474 of SEQ ID No 2 by a Valine (1474V), a substitution of the residue Glutamic acid at position 670 of SEQ ID No 2 by a Glycine (E670G) and a comination thereof. The invention also relates to an isolated or purified NARC-1 protein or a fragment thereof comprising an alteration disclosed in Table 4.

[0035] The invention further relates to a recombinant nucleic acid encoding a NARC-1 protein or a fragment thereof comprising an alteration according to the present invention, a vector comprising said nucleic acid, a host cell comprising said vector or said recombinant nucleic acid, and a non-human host organism comprising said recombinant nucleic acid, said vector or said host cell.

[0036] Therefore, the invention concerns an isolated or recombinant PCSK9 gene and/or NARC-1 protein comprising an alteration causing hypercholesterolemia, more particularly ADH, said alteration reducing, modifying or abolishing the activity of NARC-1. In this context, by modifying is intended a change of specificity of the NARC-1 protein. Optionally, said alteration decreases or abolishes the stability of the NARC-1 protein. Optionally, said alteration decreases or abolishes the stability of MRNA encoding NARC-1. Optionally, said alteration reduces the transcription rate of the PCSK9 gene. Optionally, said alteration decreases or abolishes the activity of the NARC-1 protein. Optionally, said alteration decreases or abolishes the specificity of NARC-1 for at least one of its natural substrates. Optionally, said alteration introduces a new specificity of NARC-1 for an unusual substrate. Said unusual substrate is preferably involved in cholesterol and/or lipoprotein metabolism. Optionally, said alteration hinders or prevents the NARC-1 polymerization. Optionally, said alteration affects the catalytic site of NARC-1. Optionally, said alteration affects substrate recognition site of NARC-1. Optionally, said alteration affects the processing of pro-NARC-1 in NARC-1. More particularly, said alteration reduces or prevents the autocatalytic cleavage at one of the two zymogen processing sites or at both zymogen processing sites. Optionally, said alteration modifies the association between the NARC-1 and its prosegment, for example by increasing or decreasing their interaction.

[0037] By “decrease”, it is intended within the context of this invention that the assessed parameter is between 10% and 90% of the parameter value with a wild-type NARC-1 protein in a wild-type environment. More preferably, said assessed parameter is between 25% and 75% of the parameter value with a wild-type NARC-1 protein in a wild-type environment. By “abolish”, it is intended within the context of this invention that the assessed parameter is less than 10% of the parameter value with a wild-type NARC-1 protein in a wild-type environment. More preferably, said assessed parameter is less than 5% of the parameter value with a wild-type NARC-1 protein in a wild-type environment. Still more preferably, said assessed parameter is less than 1% of the parameter value with a wild-type NARC-1 protein in a wild-type environment.

[0038] In a particular embodiment, said alteration decreases or abolishes the catalytic activity of NARC-1. Preferably, said alteration is located near the catalytic site of the NARC-1 protein. Preferably, this alteration is located near a residue of the catalytic site selected from the group consisting of Aspartic acid at position 186, Serine at position 188, Histidine at position 226, Asparagine at position 317 and Serine at position 386. More preferably, this alteration is located near the histidine in position 226. Alternatively, said alteration can be located at one or several residues of the catalytic site selected from the group consisting of Aspartic acid at position 186, Serine at position 188, Histidine at position 226, Asparagine at position 317 and Serine at position 386.

[0039] In an other preferred embodiment, said alteration decreases the autocatalytically cleavage of the NARC-1 protein. Preferably, said alteration is located near the zymogen processing sites of NARC-1. Said zymogen processing sites are located at positions 78-82 and 138-142. Alternatively, said alteration can be located at one or several residues of the zymogen processing sites of NARC-1.

[0040] In terms of amino acid sequence, the term “near” designates,within the context of this invention, an alteration located at less than 90 amino acids, preferably 60-30 amino acids, more preferably 20 amino acids, from one residue of the catalytic site or the zymogen processing site. It is also intended that the term “near” does not include residues that form part of the catalytic site or of the zymogen processing site, as defined in the present invention.

[0041] In terms of nucleotide sequence, the term “near” indicates that the alteration is located at less than 270 nucleotides, preferably 180-90 nucleotides, more preferably 60 nucleotides, from one nucleotide comprised in a codon encoding a residue of the catalytic site or of the zymogen processing site. Such alteration preferably changes the codon, thereby changing the amino acid at that position in the protein sequence.

[0042] In a particular embodiment, the invention concerns an isolated or recombinant PCSK9 gene and/or an isolated or purified NARC-1 protein comprising an alteration, said alteration being preferably located at the following positions: 1-30, 32-66, 68-77, 83-225, 227-532 and 534-692 of SEQ ID No 2.

[0043] Said alteration of the PCSK9 gene can be a mutation (e.g., a nucleotide substitution), a deletion or an addition of at least one nucleotide. Preferably, said alteration is a point mutation. More preferably, said mutation is selected from the group consisting of a substitution of the nucleotide at position 625 and/or 890. More preferably, said mutation is selected from the group consisting of a T→A substitution at nucleotide 625 of SEQ ID No 1, a T→C substitution at nucleotide 890 of SEQ ID No 1 and a combination thereof. In this regard, a specific object of the invention concerns a polynucleotide sequence of SEQ ID No 1 or a polynucleotide comprising a fragment of SEQ ID No 1, said polynucleotide comprising either the nucleotide A at position 625 or the nucleotide C at position 890 or a combination thereof. An other specific object of the present invention concerns a polynucleotide sequence of SEQ ID No 3 or a polynucleotide comprising a fragment of SEQ ID No 3, said polynucleotide comprising either the nucleotide A at position 5158 or the nucleotide C at position 13539 or a combination thereof.

[0044] A fragment of a PCSK9 gene designates any portion of at least about 8 consecutive nucleotides of a sequence as disclosed above, preferably at least about 15, more preferably at least about 20 nucleotides, further preferably of at least 30 nucleotides. Fragments include all possible nucleotide length between 8 and 100 nucleotides, preferably between 15 and 100, more preferably between 20 and 100. Said fragment can be useful as primer or probe for identifying an alteration of the PCSK9 gene in a sample of a subject or for genotyping a PCSK9 polymorphism, preferably a polymorphism disclosed in Table 2. Said fragment can be a reagent of a diagnostic kit.

[0045] The alteration of the NARC-1 protein can be a substitution, a deletion or an addition of at least one amino acid. Preferably, said alteration is a substitution. More preferably, said substitution is selected from the group consisting of a substitution of the residue Serine at position 127 of SEQ ID No 2, a substitution of the residue Phenylalanine at position 216 of SEQ ID No 2 and a combination thereof. Still more preferably, said substitution is selected from the group consisting of a substitution of the residue Serine at position 127 of SEQ ID No 2 by an Arginine (S127R), a substitution of the residue Phenylalanine at position 216 of SEQ ID No 2 by a Leucine (F216L) and a combination thereof. In this respect, a specific object of this invention concerns a polypeptide sequence of SEQ ID No 2 or a polypeptide comprising a fragment of SEQ ID No 2, said polypeptide comprising either the residue Arginine at position 127 or the residue Leucine at position 216 or a combination thereof. The invention also concerns a polynucleotide encoding said altered NARC-1 protein.

[0046] A fragment of a NARC-1 protein designates any portion of at least about 8 consecutive amino acids of a sequence as disclosed above, preferably at least about 15, more preferably at least about 20 amino acids, further preferably of at least 30 amino acids. Fragments include all possible nucleotide length between 8 and 100 amino acids, preferably between 15 and 100, more preferably between 20 and 100. Said fragment can be useful for preparing antibodies.

[0047] The invention also relates to an antibody specific of a NARC-1 protein comprising an alteration according to the present invention. In a preferred embodiment, said alteration causes hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. More preferably, the invention relates to an antibody specific of a NARC-1 protein comprising a substitution of the residue Serine at position 127 of SEQ ID No 2 by an Arginine (S127R) or a substitution of the residue Phenylalanine at position 216 of SEQ ID No 2 by a Leucine (F216L) or a combination thereof. Furthermore, the invention relates to an antibody specific of a NARC-1 protein comprising an alteration selected from the group consisting of an insertion of a residue Leucine at position 15 of SEQ ID No 2, a substitution of the residue Arginine at position 46 of SEQ ID No 2 by a Leucine (R46L), a substitution of the residue Alanine at position 53 of SEQ ID No 2 by a Valine (A53V), a substitution of the residue Isoleucine at position 474 of SEQ ID No 2 by a Valine (I474V), a substitution of the residue Glutamic acid at position 670 of SEQ ID No 2 by a Glycine (E670G) and a comination thereof. Moreover, the invention relates to an antibody specific of a NARC-1 protein comprising an alteration disclosed in Table 4, preferably selected from the group consisting of a substitution of the residue Tyrosine at position 78 of SEQ ID No 2, a substitution of the residue Valine at position 80 of SEQ ID No 2, a substitution of the residue Leucine at position 82 of SEQ ID No 2, a substitution of the residues Valine at positions 79, 80 and 81 of SEQ ID No 2, a substitution of the residues Alanines at positions 102 and 103 of SEQ ID No 2, a substitution of the residues Valine at position 79, Lysine at position 83, and Leucine at position 112 of SEQ ID No 2, a substitution of the residue Methionine at position 126 of SEQ ID No 2, a substitution of the residue Proline at position 138 of SEQ ID No 2, a substitution of the residue Isoleucine at position 143 of SEQ ID No 2, a substitution of the residue Histidine at position 226 of SEQ ID No 2, and a substitution of the residue Asparagine at position 317 of SEQ ID No 2. More preferably, said alteration is selected from the group consisting of a substitution of the residue Tyrosine at position 78 of SEQ ID No 2 by an Alanine (Y78A), a substitution of the residue Valine at position 80 of SEQ ID No 2 by an Alanine or a Leucine (V80A or V80L), a substitution of the residue Leucine at position 82 of SEQ ID No 2 by an Alanine, a Valine or a Proline (L82A, L82V or L82P), a substitution of the residues Valine at positions 79, 80 and 81 of SEQ ID No 2 by an Arginine, an Arginine and a Leucine, respectively (V79R, V80R and V81L), a substitution of the residues Alanines at positions 102 and 103 of SEQ ID No 2 by Arginines (A102R and A103R), a substitution of the residues Valine at position 79, Lysine at position 83, and Leucine at position 112 of SEQ ID No 2 by an Isoleucine, a Methionine, a Proline, respectively (V791, K83M and L112P), a substitution of the residue Methionine at position 126 of SEQ ID No 2 by an Alanine (M126A), a substitution of the residue Proline at position 138 of SEQ ID No 2 by a Tyrosine (P138Y), a substitution of the residue Isoleucine at position 143 of SEQ ID No 2 by a Proline (I143P), a substitution of the residue Histidine at position 226 of SEQ ID No 2 by an Alanine (H226A), and a substitution of the residue Asparagine at position 317 of SEQ ID No 2 by an Alanine (N317A). By “specific” is intended binds specifically the altered polypeptide and essentially does not bind specifically the wild-type polypeptide or the binding of the two forms can be discriminated.

[0048] Another object of the present invention is an altered PCSK9 gene having at least one nucleotide mutation at a position listed in Table 2. More particularly, the invention concerns an altered PCSK9 gene having the Leucine stretch modification, the corresponding encoded NARC-1 protein and the use thereof.

[0049] A further aspect of this invention resides in novel products for use in diagnosis, therapy or screening of hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. These products comprise nucleic acid molecules encoding a NARC-1 polypeptide according to the present invention, vectors comprising the same, recombinant host cells and expressed polypeptides.

[0050] A further object of this invention is a vector comprising a nucleic acid encoding a NARC-1 polypeptide comprising an alteration according to the present invention. The vector may be a cloning vector or, more preferably, an expression vector, i.e., a vector comprising regulatory sequences causing expression of a NARC-1 polypeptide from said vector in a competent host cell.

[0051] These vectors can be used to express a NARC-1 polypeptide according to the present invention in vitro, ex vivo or in vivo, to create transgenic or “Knock Out” non-human animals, to amplify the nucleic acids, to express antisense RNAs, etc.

[0052] The vectors of this invention typically comprise a NARC-1 coding sequence according to the present invention operably linked to regulatory sequences, e.g., a promoter, a polyA, etc. The term “operably linked” indicates that the coding and regulatory sequences are functionally associated so that the regulatory sequences cause expression (e.g., transcription) of the coding sequences. The vectors may further comprise one or several origins of replication and/or selectable markers. The promoter region may be homologous or heterologous with respect to the coding sequence, and provide for ubiquitous, constitutive, regulated and/or tissue specific expression, in any appropriate host cell, including for in vivo use. Examples of promoters include bacterial promoters (T7, pTAC, Trp promoter, etc.), viral promoters (LTR, TK, CMV-IE, etc.), mammalian gene promoters (albumin, PGK, etc), and the like.

[0053] The vector may be a plasmid, a virus, a cosmid, a phage, a BAC, a YAC, etc. Plasmid vectors may be prepared from commercially available vectors such as pBluescript, pUC, pBR, etc. Viral vectors may be produced from baculoviruses, retroviruses, adenoviruses, AAVs, etc., according to recombinant DNA techniques known in the art.

[0054] In this regard, a particular object of this invention resides in a recombinant virus encoding an altered NARC-1 polypeptide according to the present invention. The recombinant virus is preferably replication-defective, even more preferably selected from E1- and/or E4-defective adenoviruses, Gag-, pol- and/or env-defective retroviruses and Rep- and/or Cap-defective AAVs. Such recombinant viruses may be produced by techniques known in the art, such as by transfecting packaging cells or by transient transfection with helper plasmids or viruses. Typical examples of virus packaging cells include PA317 cells, PsiCRIP cells, GPenv+cells, 293 cells, etc. Detailed protocols for producing such replication-defective recombinant viruses may be found for instance in W095/14785, W096/22378, U.S. Pat. No. 5,882,877, U.S. Pat. No. 6,013,516, U.S. Pat. No. 4,861,719, U.S. Pat. No. 5,278,056 and W094/19478.

[0055] A further object of the present invention resides in a recombinant host cell comprising a recombinant PCSK9 gene according to the present invention or a vector as defined above. Suitable host cells include, without limitation, prokaryotic cells (such as bacteria) and eukaryotic cells (such as yeast cells, mammalian cells, insect cells, plant cells, etc.). Specific examples include E.coli, Kluyveromyces or Saccharomyces yeasts, mammalian cell lines (e.g., Vero cells, CHO cells, 3T3 cells, COS cells, etc.) as well as primary or established mammalian cell cultures (e.g., produced from lymphoblasts, fibroblasts, embryonic cells, epithelial cells, nervous cells, adipocytes, etc.). More particularly, the invention contemplates liver and small intestine and cells thereof or derived thereof.

[0056] The present invention also relates to a method for producing a recombinant host cell expressing a NARC-1 polypeptide comprising an alteration according to the present invention, said method comprising (i) introducing in vitro or ex vivo into a competent host cell a recombinant nucleic acid or a vector as described above, (ii) culturing in vitro or ex vivo the recombinant host cells obtained and (iii), optionally, selecting the cells which express and/or secrete said NARC-1 polypeptide.

[0057] Such recombinant host cells can be used for the production of NARC-1 polypeptides according to the present invention, as well as for screening of active molecules, as described below. Such cells may also be used as a model system to study hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. These cells can be maintained in suitable culture media, such as DMEM, RPMI, HAM, etc., in any appropriate culture device (plate, flask, dish, tube, pouch, etc.).

[0058] Diagnosis

[0059] The invention now provides diagnosis methods based on a monitoring of alteration at the PCSK9 gene locus in a subject. Within the context of the present invention, the term “diagnosis” includes the detection, monitoring, dosing, comparison, etc., at various stages, including early, pre-symptomatic stages, and late stages, in adults, children and pre-birth. Diagnosis typically includes the prognosis, the assessment of a predisposition or risk of development, the characterization of a subject to define most appropriate treatment (pharmaco-genetics), etc.

[0060] A particular object of this invention resides in a method of detecting the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an alteration in the PCSK9 gene locus in said sample, the presence of said alteration is indicative of the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. Preferably, said alteration is a nucleotide substitution. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0061] A particular object of this invention resides in a method of detecting the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an alteration in the NARC-1 MRNA in said sample, the presence of said alteration is indicative of the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. Preferably, said alteration is a nucleotide substitution. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0062] An additional particular object of this invention resides in a method of detecting the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an alteration in the NARC-1 polypeptide in said sample, the presence of said alteration is indicative of the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. Preferably, said alteration is an amino acid substitution. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0063] An other particular object of this invention resides in a method of assessing the response of a subject to a treatment of hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an alteration in the PCSK9 gene locus, in the NARC-1 MRNA or in the NARC-1 polypeptide in said sample, the presence of said alteration is indicative of a particular response to said treatment. Preferably, said alteration is a nucleotide or amino acid substitution. More preferably, the invention concerns a method of assessing the response of a subject to a treatment of ADH.

[0064] A further object of the present invention resides in a method of detecting the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an alteration in the PCSK9 gene, the LDL receptor gene and/or the apolipoprotein B gene in said sample, the presence of said alteration is indicative of the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. Similarly, the alteration can also be detected at the protein level. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0065] An alteration in the gene may be any form of mutation(s), deletion(s), rearrangement(s) and/or insertions in the coding and/or non-coding region of the locus, alone or in various combination(s). Mutations more specifically include point mutations, as disclosed above. In a preferred embodiment of the present invention, the alteration is a nucleotide or amino acid substitution.

[0066] The detection of the presence of an altered PCSK9 gene or an altered NARC-1 MRNA sequence according to the present invention can be performed by sequencing all or part of the PCSK9 gene, polypeptide or RNA, by selective hybridisation or by selective amplification, for instance.

[0067] A more specific embodiment comprises detecting the presence of a polymorphism as disclosed in Table 2 in the PCSK9 gene sequence or NARC-1 mRNA of a subject.

[0068] More particularly, the alteration of the PCSK9 gene locus is detected through an haplotype segregating with the mutation causing ADH, more preferably the haplotype (polymorphisms B (absence of insertion), H, I, M and U of Table 2).

[0069] Preferably, the alteration detected in the PCSK9 gene locus or NARC-1 mRNA is selected from the group consisting of a substitution of the nucleotide T at position 625 and 890 of SEQ ID No 1 and a combination thereof, more preferably a T→A substitution at position 625 of SEQ ID No 1, a T→C substitution at position 890 of SEQ ID No 1 and a combination thereof.

[0070] Alternatively, the alteration detected in the PCSK9 gene locus or NARC-1 mRNA can also be selected from the group consisting of a substitution of the nucleotide A at position 898 and a substitution of the nucleotide C at position 953 of SEQ ID No 1 and a combination thereof, more preferably a A→T substitution at position 898 of SEQ ID No 1, a C→T substitution at position 953 of SEQ ID No 1 and a combination thereof.

[0071] Preferably, the alteration detected in the NARC-1 protein is selected from the group consisting of a substitution of the residue Serine at position 127 of SEQ ID No 2, a substitution of the residue Phenylalanine at position 216 of SEQ ID No 2 and a combination thereof, more preferably a substitution of the residue Serine at position 127 of SEQ ID No 2 by an Arginine (S127R) or a substitution of the residue Phenylalanine at position 216 of SEQ ID No 2 by a Leucine (F216L) or a combination thereof.

[0072] Alternatively, the alteration detected in the NARC-1 protein can also be selected from the group consisting of a substitution of the residue Arginine at position 218 of SEQ ID No 2, a substitution of the residue Arginine at position 237 of SEQ ID No 2 and a combination thereof, more preferably a substitution of the residue Arginine at position 218 of SEQ ID No 2 by a Serine (R218S) or a substitution of the residue Arginine at position 237 of SEQ ID No 2 by a Tryptophane (R237W) or a combination thereof.

[0073] An object of the present invention resides in a method of detecting the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an altered NARC-1 RNA and/or polypeptide expression, the presence of said altered NARC-1 RNA and/or polypeptide expression is indicative of the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0074] An object of the present invention resides in a method of assessing the response of a subject to a treatment of hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an altered NARC-1 RNA and/or polypeptide expression, the presence of said altered NARC-1 RNA and/or polypeptide expression is indicative of a particular response to said treatment. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0075] Altered RNA expression includes the presence of an altered RNA sequence, the presence of an altered RNA splicing or processing, the presence of an altered quantity of RNA, etc. These may be detected by various techniques known in the art, including by sequencing all or part of the NARC-1 RNA or by selective hybridisation or selective amplification of all or part of said RNA, for instance.

[0076] Altered NARC-1 polypeptide expression includes the presence of an altered polypeptide sequence, the presence of an altered quantity of NARC-1 polypeptide, the presence of an altered tissue distribution, etc. These may be detected by various techniques known in the art, including by sequencing and/or binding to specific ligands (such as antibodies), for instance.

[0077] A further object of the present invention resides in a method of detecting the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an altered NARC-1 activity, the presence of said altered NARC-1 activity is indicative of the presence of or predisposition to hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders. Preferably, said altered NARC-1 activity is a decreased NARC-1 activity. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0078] A further object of the present invention resides in a method of assessing the response of a subject to a treatment of hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an altered NARC-1 activity, the presence of said altered NARC-1 activity is indicative of a particular response to said treatment. Preferably, said altered NARC-1 activity is a decreased NARC-1 activity. More preferably, the invention concerns a method of detecting the presence of or predisposition to ADH.

[0079] An object of the present invention resides in a method of genotyping at least one polymorphism of the PCSK9 gene, preferably listed in Table 2, comprising (i) providing a sample from the subject and (ii) determining the identity of the allele of said polymorphism in said sample. Preferably, the identity of the allele is determined by performing a hydridization assay, a sequencing assay, a microsequencing assay, an allele-specific amplification assay.

[0080] The present invention also relates to a method of determining the existence of an association between a polymorphism and a disease or disorder, comprising the steps of: (i) genotyping at least one polymorphism of the PCSK9 gene, preferably one listed in Table 2, in a population having said disease or disorder; (ii) genotyping said polymorphism: in a control population; and, (iii) determining whether a statistically significant association exists between said disease or disorder and said polymorphism.

[0081] As indicated above, various techniques known in the art may be used to detect or quantify altered PCSK9 gene or RNA expression or sequence, including sequencing, hybridisation, amplification and/or binding to specific ligands (such as antibodies). Other suitable methods include allele-specific oligonucleotide (ASO), allele-specific amplification, Southern blot (for DNAs), Northern blot (for RNAs), single-stranded conformation analysis (SSCA), PFGE, fluorescent in situ hybridization (FISH), gel migration, clamped denaturing gel electrophoresis, heteroduplex analysis, RNase protection, chemical mismatch cleavage, ELISA, radio-immunoassays (RIA) and immuno-enzymatic assays (IEMA).

[0082] Some of these approaches (e.g., SSCA and CGGE) are based on a change in electrophoretic mobility of the nucleic acids, as a result of the presence of an altered sequence. According to these techniques, the altered sequence is visualized by a shift in mobility on gels. The fragments may then be sequenced to confirm the alteration. Some others are based on specific hybridization between nucleic acids from the subject and a probe specific for wild-type or altered PCSK9 gene or RNA. The probe may be in suspension or immobilized on a substrate. The probe is typically labelled to facilitate detection of hybrids. By “specific hybridization” is intended a hybridization under stringent conditions.

[0083] Some of these approaches are particularly suited for assessing a polypeptide sequence or expression level, such as Northern blot, ELISA and RIA. These latter require the use of a ligand specific for the polypeptide, more preferably of a specific antibody.

[0084] Sequencing can be carried out using techniques well known in the art, using automatic sequencers. The sequencing may be performed on the complete PCSK9 gene or, more preferably, on specific domains thereof, typically those known or suspected to carry deleterious mutations or other alterations.

[0085] Amplification may be performed according to various techniques known in the art, such as by polymerase chain reaction (PCR), ligase chain reaction (LCR), strand displacement amplification (SDA) and nucleic acid sequence based amplification (NASBA). These techniques can be performed using commercially available reagents and protocols. Preferred techniques use allele-specific PCR or PCR-SSCP. Amplification usually requires the use of specific nucleic acid primers, to initiate the reaction.

[0086] In this regard, a particular object of this invention resides in a nucleic acid primer useful for amplifying sequences from the PCSK9 gene or locus. Such primers are preferably complementary to, and hybridize specifically under stringent conditions to nucleic acid sequences in the PCSK9 gene locus. Particular primers are able to specifically hybridise under stringent conditions with a portion of the PCSK9 gene locus that flank a target region of said locus, said region comprising an alteration according to the present invention, more particularly a substitution of the nucleotide T at position 625 and /or 890 of SEQ ID No 1 or a polymorphism listed in Table 2, preferably said target region being altered in certain subjects having ADH.

[0087] A aspect of this invention includes a pair of nucleic acid primers, wherein said pair comprises a sense and a reverse primers, and wherein said sense and a reverse primers specifically amplify a PCSK9 gene or RNA or a target region thereof, said region comprising an alteration according to the present invention, more particularly a substitution of the nucleotide T at position 625 and /or 890 of SEQ ID No 1 or a polymorphism listed in Table 2, preferably said target region being altered in certain subjects having hypercholesterolemia, more particularly ADH and/or lipid and lipoprotein metabolism disoders.

[0088] In a more specific embodiment, the invention relates to a nucleic acid primer, wherein said primer is complementary to and hybridizes specifically under stringent conditions to a portion of a PCSK9 coding sequence (e.g., gene or RNA), wherein said portion comprising an alteration according to the present invention, more particularly a substitution of the nucleotide T at position 625 and /or 890 of SEQ ID No 1 or a polymorphism listed in Table 2. Preferably, said alteration is present in certain subjects having hypercholesterolemia, more particularly ADH and/or lipid and lipoprotein metabolism disoders. In this regard, particular primers of this invention are specific for altered sequences in a PCSK9 gene or RNA. By using such primers, the detection of an amplification product indicates the presence of an alteration in the PCSK9 gene locus. In contrast, the absence of amplification product indicates that the specific alteration is not present in the sample. More preferably, said primers comprises the nucleotide at position 625 and/or 890 of SEQ ID No 1, or the nucleotide at position 5158 and/or 13539 of SEQ ID No 3. Alternatively, said primers comprises one polymorphism listed in Table 2.

[0089] Typical primers of this invention are single-stranded nucleic acid molecules of about 5 to 60 nucleotides in length, more preferably of about 8 to about 25 nucleotides in length. The sequence can be derived directly from the sequence of the PCSK9 gene locus. Perfect complementarity is preferred, to ensure high specificity. However, certain mismatch may be tolerated.

[0090] A particular detection technique involves the use of a nucleic acid probe specific for wild-type or altered PCSK9 gene or RNA, followed by the detection of the presence of a hybrid. The probe may be in suspension or immobilized on a substrate or support (as in nucleic acid array or chips technologies). The probe is typically labelled to facilitate detection of hybrids.

[0091] In this regard, a particular embodiment of this invention comprises contacting the sample from the subject with a nucleic acid probe specific for an altered PCSK9 gene locus, and assessing the formation of an hybrid. In a particular, preferred embodiment, the method comprises contacting simultaneously the sample with a set of probes that are specific, respectively, for wild type PCSK9 gene locus and for various altered forms thereof. In this embodiment, it is possible to detect directly the presence of various forms of alterations in the PCSK9 gene locus in the sample. Also, various samples from various subjects may be treated in parallel.

[0092] A further particular object of this invention resides in a nucleic acid probe specific for a PCSK9 gene or RNA. Within the context of this invention, a probe refers to a polynucleotide sequence which is complementary to and capable of specific hybridisation under stringent conditions with a (target portion of a) PCSK9 gene or RNA, and which is suitable for detecting polynucleotide polymorphisms, preferably the polymorphism associated with PCSK9 alleles which predispose to or are associated with ADH. Probes are preferably perfectly complementary to the PCSK9 gene, RNA, or target portion thereof. Probes typically comprise single-stranded nucleic acids of between 8 to 1000 nucleotides in length, for instance of between 10 and 800, more preferably of between 15 and 700, typically of between 20 and 500. It should be understood that longer probes may be used as well. A preferred probe of this invention is a single stranded nucleic acid molecule of between 8 to 500 nucleotides in length, which can specifically hybridise under stringent conditions to a region of a PCSK9 gene or RNA that carries an alteration.

[0093] A specific embodiment of this invention is a nucleic acid probe specific for an altered (e.g., a mutated) PCSK9 gene or RNA, i.e., a nucleic acid probe that specifically hybridises under stringent conditions to said altered PCSK9 gene or RNA and essentially does not hybridise under stringent conditions to a PCSK9 gene or RNA lacking said alteration. Specificity indicates that hybridisation to the target sequence generates a specific signal which can be distinguished from the signal generated through non-specific hybridisation. Perfectly complementary sequences are preferred to design probes according to this invention. It should be understood, however, that certain mismatch may be tolerated, as long as the specific signal may be distinguished from non-specific hybridisation.

[0094] Particular examples of such probes are nucleic acid sequences complementary to a target portion of the PCSK9 gene or RNA carrying the nucleotide at position 625 and/or 890 of SEQ ID No 1, the nucleotide at position 5158 and/or 13539 of SEQ ID No 3, a polymorphism listed in Table 2, or a mutation disclosed in Table 4.

[0095] The sequence of the probes can be derived from the sequences of the PCSK9 gene and RNA as provided in the present application. Nucleotide substitutions may be performed, as well as chemical modifications of the probe. Such chemical modifications may be accomplished to increase the stability of hybrids (e.g., intercalating groups) or to label the probe. Typical examples of labels include, without limitation, radioactivity, fluorescence, luminescence, enzymatic labelling, etc.

[0096] As indicated above, alteration in the PCSK9 gene locus may also be detected by screening for alteration(s) in NARC-1 polypeptide sequence or expression levels. In this regard, a specific embodiment of this invention comprises contacting the sample with a ligand specific for an altered NARC-1 polypeptide and determining the formation of a complex.

[0097] Different types of ligands may be used, such as specific antibodies. In a specific embodiment, the sample is contacted with an antibody specific for an altered NARC-1 polypeptide and the formation of an immune complex is determined. Various methods for detecting an immune complex can be used, such as ELISA, radio-immunoassays (RIA) and immuno-enzymatic assays (IEMA).

[0098] In a specific embodiment, the method comprises contacting a sample from the subject with (a support coated with) an antibody specific for an altered form of a NARC-1 polypeptide, and determining the presence of an immune complex. In a particular embodiment, the sample may be contacted simultaneously, or in parallel, or sequentially, with various (supports coated with) antibodies specific for different forms of a NARC-1 polypeptide, such as a wild-type and various altered forms thereof.

[0099] Particular examples of such specific ligands are antibodies specific for altered NARC-1 polypeptide sequence resulting from any mutation in position 127 and/or 216, more particularly a substitution of the residue Serine at position 127 by an Arginine (S 127R) or a substitution of the residue Phenylalanine at position 216 by a Leucine (F216L) or any combination of those mutations.

[0100] The invention also relates to a diagnostic kit comprising products and reagents for detecting in a sample from a subject the presence of an alteration in the PCSK9 gene or in the NARC-1 protein, in the NARC-1 RNA or polypeptide expression, and/or in NARC-1 activity. Optionally, said diagnostic kit further comprises reagents for detecting in a sample from a subject the presence of an alteration in the LDL receptor and/or the apolipoprotein B. Said diagnostic kit according to the present invention comprises any primer, any pair of primers, any nucleic acid probe and/or any antibody described in the present invention. Said diagnostic kit according to the present invention can further comprise reagents and/or protocols for performing a hybridization, amplification or antigen-antibody immune reaction.

[0101] SCREENING

[0102] The present invention also provides novel targets and methods for the screening of drug candidates or leads. Such drug candidates or leads are useful for developping a treatment against hypercholesterolemia, more particularly ADH, lipid and lipoprotein metabolism disorders, atherosclerosis, and/or CVD. Preferably, such drug candidates or leads are useful for developping a treatment against ADH. The methods include binding assays and/or functional assays, and may be performed in vitro, in cell systems, in animals, etc. Functional assays comprise, but are not limited to, the cleavage of a substrate. The in vitro assays, cell-based assays and animal-based assays involve a NARC-1 protein, preferably a NARC-1 protein comprising an alteration according to the present invention. Optionally, said assays comprise a control with a natural NARC-1 protein.

[0103] For cell systems, cells can be native, i.e., cells that normally express the NARC-1 polypeptide, as a biopsy or expanded in cell culture. Preferably, these native cells are derived from liver or small intestine. Alternatively, cells are recombinant host cells expressing NARC-1, more particularly a NARC-1 protein comprising an alteration according to the present invention.

[0104] The invention relates to methods for identifying of the target proteins of the NARC-1 protein, preferably a NARC-1 protein comprising an alteration according to the present invention.

[0105] The invention relates to methods for screening of compounds that modulate the NARC-1 activity. Such compounds, for example, can increase or decrease affinity and/or rate of binding of the NARC-1 protein to the substrate, compete with substrate for binding to the NARC-1 protein, or displace substrate bound to the NARC-1 protein. Preferably, the invention concerns methods for screening of compounds that increase or restore the natural NARC-1 activity. By “natural” NARC-1 activity is intended the activity of the wild-type NARC-1 protein. Furthermore, the invention concerns methods for screening of compounds that inhibit the activity of the altered NARC-1 comprising an alteration changing the substrate specificity and, thereby generating new substrates. Said compounds are able to block the activity of the altered NARC-1 for its new substrate.

[0106] Therefore, the present invention concerns a method of selecting biologically active compounds, said method comprising contacting a test compound with an altered PCSK9 gene or an altered NARC-1 protein or fragment thereof of at least 15 consecutive residues comprising an alteration, wherein the alteration reduces, modifies, or abolishes the activity of NARC-1, and determining the ability of said test compound to modulate the expression and/or activity of said gene or protein or fragment.

[0107] A particular object of this invention resides in a method of selecting biologically active compounds, said method comprising contacting in vitro a test compound with a PCSK9 gene or NARC-1 polypeptide, preferably a PCSK9 gene or a NARC-1 polypeptide, or a fragment thereof of at least 15 consecutive residues, comprising an alteration according to the present invention, and determining the ability of said test compound to bind said PCSK9 gene or NARC-1 polypeptide. Binding to said gene or polypeptide provides an indication as to the ability of the compound to modulate the activity of said target, and thus to affect a pathway leading to hypercholeterolemia, more particularly ADH, and lipid and/or lipoprotein metabolism disorders in a subject. In a preferred embodiment, the method comprises contacting in vitro a test compound with a NARC-1 polypeptide or a fragment thereof, preferably a NARC-1 polypeptide or a fragment thereof comprising an alteration according to the present invention, and determining the ability of said test compound to bind said NARC-1 polypeptide or fragment. The fragment preferably comprises a substrate-binding site of the NARC-1 polypeptide.

[0108] A particular object of this invention resides in a method of selecting compounds active against hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders, said method comprising contacting in vitro a test compound with a NARC-1 polypeptide or a fragment thereof of at least 15 consecutive residues, preferably a NARC-1 polypeptide or a fragment thereof comprising an alteration according to the present invention, and determining the ability of said test compound to bind said NARC-1 polypeptide or fragment thereof. The NARC-1 polypeptide or fragment thereof may be used in essentially pure form, in suspension, or immobilized on a support.

[0109] In a futher particular embodiment, the method comprises contacting a recombinant host cell expressing NARC-1 polypeptide, preferably a NARC-1 polypeptide comprising an alteration according to the present invention, with a test compound, and determining the ability of said test compound to bind said NARC-1 polypeptide and/or to modulate the activity of NARC-1 polypeptide.

[0110] The determination of binding may be performed by various techniques, such as by labelling of the test compound, by competition with a labelled reference ligand, two-hybrid Screening Assay, etc. Modulation of activity includes, without limitation, the inhibition or activation of the autocatalytic processing of pro-NARC-1, and/or the inhibition or activation of the substrate cleavage, more particularly a synthetic substrate comprising a zymogenic processing site.

[0111] A further object of this invention resides in a method of selecting biologically active compounds, said method comprising contacting in vitro a test compound with a NARC-1 polypeptide, preferably a NARC-1 polypeptide comprising an alteration according to the present invention, and determining the ability of said test compound to modulate the activity of said NARC-1 polypeptide.

[0112] A further object of this invention resides in a method of selecting biologically active compounds, said method comprising contacting in vitro a test compound with a PCSK9 gene, preferably a PCSK9 gene comprising an alteration according to the present invention, and determining the ability of said test compound to modulate the expression of said PCSK9 gene.

[0113] The invention also concerns methods of selecting biologically active compounds using a non-human transgenic animals expressing a NARC-1 protein, preferably a NARC-1 protein comprising an alteration according to the present invention. Optionally, said non-human transgenic animals can be homozygote or heterozygote for the altered PCSK9 gene. Said methods comprise (i) administrating a test compound to said non-human transgenic animal, and (ii) determining the ability of said test compound to modulate the NARC-1 activity. Said NARC-1 activity can be assessed by determining the plasmatic concentration of cholesterol and/or lipoparticules (VLDL, IDL, LDL), by determining the plasmatic enzymatic activity of NARC-1, by analyzing some tissues (liver, small intestine), by determining the lipoprotein kinetics. The enzymatic activity of NARC-1 can be determined with synthetic substrate, such as described in Seidah et al (2003).

[0114] The above screening assays may be performed in any suitable device, such as plates, tubes, dishes, flasks, etc. Typically, the assay is performed in multi-wells plates. Several test compounds can be assayed in parallel.

[0115] Furthermore, the test compound may be of various origin, nature and composition. It may be any organic or inorganic substance, such as a lipid, peptide, polypeptide, nucleic acid, small molecule, etc., in isolated or in mixture with other substances. The compounds may be all or part of a combinatorial library of products, for instance. The test compounds can be an antisense or an RNAi. The test compounds can be competitive or suicide substrates. By “suicide substate” is intended a compounds that, after binding NARC-1 protein, the reactive group forms an irreversible bond with NARC-1 rendering it inactive.

[0116] Therapy

[0117] The invention contemplates methods of treatment of hypercholesterolemia, more particularly ADH, lipid and lipoprotein metabolism disorders, atherosclerosis and/or CVD. Preferably, the invention relates to methods of treatment of hypercholesterolemia, more particularly ADH, and/or lipid and lipoprotein metabolism disorders due to an alteration of NARC-1 protein.

[0118] The invention also relates to a method of treating or preventing hypercholesterolemia, more particularly ADH, lipid and lipoprotein metabolism disorders, atherosclerosis and/or CVD in a subject, the method comprising administering to said subject a functional (e.g., wild-type) NARC-1 polypeptide or a nucleic acid encoding the same. More preferably, the invention concerns a method of treating or preventing ADH.

[0119] The invention concerns the use of a functional NARC-1 polypeptide or a nucleic acid encoding the same, in the manufacture of a pharmaceutical composition for treating or preventing hypercholesterolemia, more particularly ADH, lipid and lipoprotein metabolism disorders, atherosclerosis and/or CVD in a subject. More preferably, the invention concerns a pharmaceutical composition for treating or preventing ADH.

[0120] The invention also relates to a method of treating or preventing hypercholesterolemia, more particularly ADH, lipid and lipoprotein metabolism disorders, atherosclerosis and/or CVD in a subject, the method comprising administering to said subject a compound that modulates NARC-1 expression and/or activity. More preferably, the invention concerns a method of treating or preventing ADH. The invention further relates to a pharmaceutical composition comprising a compound that modulates NARC-1 expression and/or activity.

[0121] The invention relates, generally, to the use of a compound that modulates NARC-1 expression and/or activity in the manufacture of a pharmaceutical composition for treating or preventing hypercholesterolemia, more particularly ADH, lipid and lipoprotein metabolism disorders, atherosclerosis and/or CVD in a subject. More preferably, the invention concerns a pharmaceutical composition for treating or preventing ADH.

[0122] The present invention demonstrates the causal link between hypercholesterolemia, more particularly ADH, and an alteration of the PCSK9 gene locus. The invention thus provides a novel target of therapeutic intervention. Various approaches can be contemplated to restore or modulate the NARC-1 activity or function, more particularly normal NARC-1 activity or function, in a subject, particularly those carrying an altered PCSK9 gene locus. Supplying wild-type function to such subject is expected to suppress phenotypic expression of hypercholesterolemia, more particularly ADH, in a pathological cell or organism. The supply of such function can be accomplished through gene or protein therapy, or by administering compounds that modulate NARC-1 activity.

[0123] If the alteration of NARC-1 protein leads to a decrease or loss of NARC-1 activity, the treatment consists in administering a biologically active compound which increases or restores the NARC-1 activity. Said biologically active compound can be a natural NARC-1 protein. Alternatively, said compound can be an activator of the NARC-1 protein. Said compound can also increase the expression of NARC-1 protein.

[0124] If the alteration of NARC-1 protein leads to a new specificity for a substrate, the treatment consists in administrating a biologically active compound which inhibits the activity of the altered NARC-1 protein. Said compound can decrease the expression of NARC-1 protein. For example, such compounds can be an antisens or an RNAi of PCSK9 gene comprising the alteration causing ADH. Alternatively, said compound can be an inhibitor of the altered NARC-1 protein. Said compound can compete with the substrate or can be a suicide substrate.

[0125] Further aspects and advantages of the present invention will be disclosed in the following experimental section, which should be regarded as illustrative and not limiting the scope of the present invention. The references cited in the present application are all incoporated herein by reference.

EXAMPLE

[0126] The inventors mapped a third locus HCHOLA3 at 1p32 and now report two mutations in the PCSK9 gene causing ADH. PCSK9 encodes NARC-1 (neural apoptosis regulated convertase). Its mutations lead to reduced activation of the enzyme. Lipoprotein kinetics in probands revealed an overproduction of apoB100-rich particles showing that the pathogenic origin of the disease is hepatic. In conclusion, NARC-1 is a newly identified human subtilase that contributes to cholesterol homeostasis and is the first example of a dominant disease associated with a defect in a member of the large subtilase family.

[0127] To identify the HCHOLA3 locus (formerly FH3), that the inventors mapped (Varret et al, 1999) to 1p34.1-p32 (OMIM603776) and was confirmed by Hunt et al. in a large Utah kindred (Hunt et al, 2000), the inventors performed positional cloning using the originally linked family and 23 French families in which the implication of the LDLR and APOB genes had been excluded.

[0128] Family HC92 was identified through the proband (HC92-II-7) who belongs to a multiplex ADH pedigree from which twenty-nine family members were sampled and tested in parametric linkage analyses. In the reduced pedigree studied in the linkage analysis, 12 subjects presented with total cholesterol levels above the 97.5 th percentile when compared with other French individuals matched by age and sex (Steinmetz, 1990) (mean total cholesterol: 3.63 g/L ±0.68, mean LDL-cholesterol: 2.87±0.72 g/L). The inventors excluded linkage to the LDLR and APOB genes [lod scores at −14.05 and −10.01 (θ=0.0), respectively]. The family was genotyped for 8 Genethon markers in the 1p34-p32 region (FIG. 1). The inventors obtained highly significant lod scores with a maximum of 4.26 (θ=0.0) at D1S2742 that reached 4.80 in the multipoint analyses (Table 1, FIG. 3a). Haplotype analysis identified a 5.9 Mb critical interval between D1S231 and D1S2890. The critical interval that our team had previously reported in the HC2 family (Varret et al, 1999) was between markers D1S472 and D1S211, thus more distal. Reexamination of haplotype data (FIG. 2) showed that all affected subjects of the HC2 family also shared the same haplotype between markers D1S2722 and D1S2890 except HC2-II-5. This “affected” subject presented a recombinational event at D1S211 thus providing the centromeric boundary of the region described in 1999. Therefore all family members were reinvestigated. HC2-II-5 (who refuses treatment) was the only subject who showed a significant variation (a marked elevation of triglycerides) and thus no longer conforms with the inclusion criteria.

[0129] The inventors established the physical map of the candidate region between D1S197 and D1S2890 covered by 82 overlapping BAC sequences released from the Human Genome Project. The region between D1S197 and D1S2890 contains 41 genes among which 8 encode interesting functional candidates with respect to lipid metabolism: EPS 15 (Epidermal growth factor receptor pathway substrate-15), OSBPL9 (Oxysterol binding protein-like 9), SCP2 (Sterol carrier protein 2), LRP8 (Low density lipoprotein receptor-related protein 8), DHCR24 (24-dehydrocholesterol reductase), PRKAA2 (Protein kinase, AMP-activated, alpha 2 catalytic subunit), DAB1 (Disabled homolog 1) and PCSK9 (encoding NARC-1). This Neural Apoptosis Regulated Convertase 1 is a novel putative proprotein convertase (PC) belonging to the subtilase subfamily (Seidah et al, 2003). A related protein is the subtilisin kexin isoenzyme-1 (SKI-1)/site-1-protease (SIP) known to play a key role in cholesterol homeostasis through the processing of the sterol regulatory element-binding proteins (SREBPs) (Brown & Goldstein, 1999; Elagoz et al, 2002). The cDNA spans 3617 bp encoding a 692 amino acid protein. NARC-1 was mapped to 1p33-p34.3. The inventors precisely localized its cDNA using the Blast program (http://www.ncbi.nlm.nih.gov/BLAST/) in the HCHOLA3 interval as follows: tel-D1S231-D1S2661-D1S417-D1S2652-PCSK9-D1S475-D1S200-D1S2742-cen.

[0130] Systematic bidirectional sequencing of the 125 exons of the first seven candidates revealed no mutation in probands. By sequencing the 12 exons of PCSK9 the inventors identified in family HC92 a T→A substitution in exon 2 at nucleotide 625 predicting a substitution at codon 127 of Arginine for the conserved Serine (S127R), thereby creating a MnlI cleavage site (FIG. 3b, FIG. 4). HC92 family members and 100 controls were tested for the substitution. It was absent in the 200 control chromosomes indicating that it is not a polymorphism. It was found in the 12 affected family members and in subject HC92-IV-3 who has a total cholesterol level in the ₉₀th percentile when compared to other French individuals matched by age and sex. Thus, the penetrance in the family is estimated at 0.94. Interestingly, the S127R mutation was also found in the proband of HC2 and cosegregated with the disease in the family except in subject HC2-II-5, confirming that he had been misclassified in the linkage analyses previously reported (Varret et al, 1999). To assess the possible recurrence of this mutation, the inventors tested 5 intragenic polymorphic markers that the inventors had identified in PCSK9 (4 SNPs and a GCT repeat) in both families. The same haplotype segregated with the S127 R mutation in both the HC2 and the HC92 family: (Polymorphisms B (absence of insertion), H, I, M, and U) (Tables 2 and 3). Furthermore, a unique haplotype was also obtained for the extragenic markers surrounding PCSK9 (D1S2661, D1S417, D1S475, D1S200 and D1S2742) in both families. These results show that despite the absence of records and different geographical origins, the families share a common ancestor. The possibility of a French founder effect was ruled out since the mutation was not found in 22 other French ADH probands.

[0131] Through systematic bidirectional sequencing of the 12 exons of the PCSK9 gene in 22 ADH probands, a second mutation (F216L) was identified in the proband of the HC60 family (FIG. 2c) who died from myocardial infarction at 49 y.o (FIG. 3d, FIG. 4). This mutation segregated with the ADH phenotype in the family and was not found in 200 control chromosomes. No major rearrangement was found in any of the probands by Southern blot (data not shown). Thus, mutations in PCSK9 have been found in 12.5% of the ADH families tested.

[0132] The inventors also identified 25 polymorphisms present in different probands and on control chromosomes from subjects with normal cholesterol levels (Table 2). These variations and their respective frequencies in the French population are listed in Table 2. It should be noted that none of these polymorphisms give rise to new donor or acceptor splice sites (score calculated according to Senapathy et al.) (Senapathy et al, 1990; Shapiro & Senapathy, 1987).

[0133] In order to unravel at the molecular level the consequences of the S127R and F216L mutations, the inventors introduced them in the human PCSK9 cDNA (Seidah et al., 2003). The inventors also obtained four other mutants, namely S127A, S127P, 15_(—)16insL (polymorphic variant where an extra leucine is added in the signal peptide hydrophobic stretch) and the active site mutant H226A (Seidah et al., 2003). The cDNAs encoding wild type (WT) NARC-1 and its mutants containing a C-terminal V5 epitope, were transiently transfected in HEK293 cells. A 4h pulse with ³⁵S-labelled Met and Cys was followed by immunoprecipitation of the cell lysates and the media with a V5 mAb (Seidah et al., 2003). The inventors have previously shown that proNARC-1 is synthesized as a 72 kDa precursor that undergoes two zymogen cleavage events. The first one is rapid and occurs in the endoplasmic reticulum (ER) at the YVVVL₈₂⇓ site, giving rise to the 63-65 kDa N1 product and the 14 kDa prosegment (pro). The second one occurs with much lower efficacy at the putative PHVDY₁₄₂⇓ site and gives rise to the presumably active 58 kDa N2 enzyme (Brown & Goldstein, 1999). By STORM quantitation the inventors estimate that both S127R and F216L mutations lead to ˜3-fold lower levels of N2. In addition, the secreted level of N1 was about 2-fold lower for the S127R mutant. Interestingly, while the S127A mutant shows a similar behavior, the S127P resembles WT. Finally, the 15_(—)16insL allelic variant seems to give rise to a ˜2-fold higher percentage of NI and N2 products, suggesting that more active NARC-1 is produced.

[0134] The inventors have identified a new gene implicated in ADH by positional cloning. Linkage analyses were performed on two large French pedigrees: HC92 and HC2 in which the implication of the LDLR and APOB genes had been excluded. A maximum lod score of 4.26 was obtained for D1S2742 in family HC92. Haplotype analysis restricted the region of linkage to a 5.9 Mb interval between markers D1S231 and D1S2890 at 1p32. Our team had previously reported the localization of HCHOLA3 at 1p32-p34.1 by. linkage analysis performed on the HC2 family (Varret et al, 1999). In this family, the critical interval was flanked by markers D1S472 and D1S211 and was thus more distal as compared to the one identified with the HC92 family. Reexamination of haplotype data showed that all affected subjects of the HC2 family also shared the same haplotype between markers D1S2722 and D1S2890 except (HC2-II-5). This “affected” subject presented a recombinational event at D1S211 thus providing the centromeric boundary of the region described in 1999. Therefore (HC2-II-5) was reinvestigated. The new lipid measurements showed the same elevated cholesterol but also marked elevation of triglycerides. This alteration can be explained by recent knowledge of a notable alcohol intake that presently prohibits proper assessment of the subject's status with respect to the family trait. Identification of the S127R PCSK9 gene mutation in all other affected members of the HC2 family and its absence in (HC2-II-5) confirmed that he had been misclassified for the genetic analyses. Identification of the S127R PCSK9 gene mutation in the HC92 family also helped to clarify the genetic status of the 8 children that had been sampled but not included in the linkage analyses. These results comforted the conservative approach that the inventors had chosen (total cholesterol above the ₉₇.₅th percentile when compared with sex- and age-matched French population) and that also allowed for reduced penetrance. This last parameter was confirmed since the S127R PCSK9 gene mutation was identified in (HC92-IV-3) who has a total cholesterol level in the 90^(th) percentile (when compared to other French individuals matched by age and sex), and had higher cholesterol levels when compared to the levels of his non-affected sisters (2.5^(th) percentile for HC92-IV-1 and 30^(th) percentile for HC92-IV-2). Thus, the penetrance can now be estimated at 0.94 in the family when considering the inclusion criteria that were applied. This characteristic of a PCSK9 gene mutation is also found with LDLR gene mutations (Hobbs et al, 1989; Sass et al, 1995) and more generally accounts for the variability of the hypercholesterolemic phenotype (evaluated by common clinical and biological criteria) that can be due to the effect of environmental factors or of modifier genes.

[0135] Haplotype analysis showed that a unique haplotype segregated with the S127R mutation in both the HC92 and HC2 families. Therefore, it can be assumed that despite the absence of records and different geographical origins, the families share a common ancestor. The possibility of a French founder effect can be ruled out since the mutation was not found in a total of 22 other French probands (data not shown).

[0136] NARC-1 is a novel convertase recently cloned by two pharmaceuticals companies (NARC-1, Millenium Pharmaceuticals and LP251, Eli Lilly). It was first identified via the cloning of cDNAs upregulated following apoptosis induced by serum deprivation in primary cerebellar neurons. NARC-1 was more precisely characterized recently by Seidah et al. who used short conserved segments of the SKI-1 catalytic subunit as baits and the Protein Blast program to identify this convertase in a patented database (Seidah et al, 2003). It is synthesized as a soluble zymogen that undergoes autocatalytic intramolecular processing in the endoplasmic reticulum (ER) at the primary cleavage site YVVVL⇓KEE⁸⁵ indicative of the enzymatic specificity (Seidah et al, 2003) of NARC-1. Prosegment cleavage is necessary for NARC-1 exit from the ER. The S127R mutation resides between the primary and putative secondary zymogen processing sites of proNARC-1, while F216L is located close to the active site (H226). Notably, the S127R mutation creates an RGD site that may be involved in integrin binding (Ruoslahti, 1996).

[0137] While only the S127R mutant causes reduction in the secreted level of N1, both the S127R and the F216L mutations result in reduced production of the enzymatically active N2. Furthermore, the kinetics of VLDL, IDL and LDL apo B 100 performed in ADH subjects carrying the S127R mutation showed an overproduction from the liver of apo B100-rich lipoproteins. Thus, the dominance of the disease shows that NARC-1 is a rate-limiting enzyme involved in cholesterol homeostasis in the liver. Although most enzymopathies are recessively inherited, dominance is reported in some highly regulated or tissue specific enzymes. This is observed in two types of porphyria: AIP (acute intermittent porphyria) (Desnick et al, 1985) and PCT (porphyria cutanea tarda) (Felsher et al, 1982), that are caused by a porphobilinogen deaminase and uroporphyrinogen decarboxylase deficiency, respectively. However, contrary to porphyria, PCSK9 gene defects seem highly penetrant. NARC-1 belongs to the 9-membered mammalian subtilase family in which only one other member was known to carry a disease-causing mutation: a compound heterozygosity in the PC1 gene results in obesity and endocrinopathy due to impaired prohormone processing (MIM 162150). However, heterozygosity for one of the mutations is silent thus suggesting a recessive transmission (Jackson et al, 1997). Although PCs activate a wide variety of proteins, it is notable that none of them was linked so far to a dominant human disease. NARC-1 is thus unique in this respect and may lead to the discovery of others. While the related convertase SKI-1/S1P plays a key role in regulating cholesterol and fatty acid homeostasis through the processing of SREBP1 and SREBP2, the precise implication of NARC-1 in cholesterol homeostasis is still under investigation. Interestingly, NARC-1 is mainly expressed in the liver and small intestine both of which play key roles in cholesterol synthesis and regulation (Seidah et al, 2003). Since apo B 100 levels are regulated post-translationally (Bostrom et al, 1988), it is possible that NARC-1 could inactivate apo B100 and hence decrease the level of LDL. Indeed, a putative site LIEIGL⇓EGK⁶⁶⁸ of apo B100 is proposed which would respect the primary and secondary structure requirements of NARC-1 processing selectivity (Seidah et al, 2003). This may thus explain the reported 70 kDa form of apo B100 that is observed to occur under stressful cellular conditions (Cavallo et al, 1999).

[0138] The crucial role of NARC-1 is revealed by the hypercholesterolemia that occurs when the gene is mutated resulting in a decreased NARC-1 activation. The identification of NARC-1 substrate(s) will help to elucidate novel disease mechanisms and constitute a target(s) for new intervention strategies to limit elevation of LDL particles and prevent morbidity and mortality from premature atherosclerosis.

[0139] Methods

[0140] Family Recruitement

[0141] The French hypercholesterolemic families were recruited through the 8 lipid clinics of the National Network for ADH (“Réseau National de Recherche sur les Hypercholestérolémies Familiales”). Probands were ascertained among consecutive patients of the clinics. Inclusion criteria for probands were: total cholesterol above the 97.5^(th) percentile when compared with sex- and age-matched French population (Steinmetz, 1990), LDL cholesterol above 1.9 g/L or 1.6 g/L for children, triglycerides below 1.5 g/L, personal or documented familial xanthomas, and/or arcus corneae, and early CVD. Lipid measurements were repeated to ascertain the existence of primary isolated hypercholesterolemia due to elevated LDL. Family history and pedigrees were investigated. Informed consent was obtained for all subjects included in this study. Family HC2 has been previously reported and described at length (Varret et al, 1999). Functional tests showed normal binding, internalization and degradation of LDL particles in fibroblasts from the probands (HC2-II-9) (Hobbs et al, 1989). Five other families (HC35, HC60, HC92, HC122, HC243) were studied representing 26 affected and 26 unaffected subjects. For affected subjects, mean total and LDL cholesterol were 3.27 g/L ±0.77 and 2.47±0.76 g/L, respectively.

[0142] DNA Analysis and Genotyping

[0143] DNA was isolated from whole blood samples as previously described (Collod et al, 1994). All families were tested with polymorphic markers of the LDLR and APOB genes. For the LDLR, two intragenic markers (D19S584 in intron 1 and the (TA)n in exon 18) and two flanking markers (D19S394 and D19S221) were studied. The 5′HVR (TG repeat) and 3′HVR (VNTR) were studied for the APOB gene and screening for the R3500Q mutation as reported (Rabes et al, 1997). Genotyping at 1p34-p32 was performed using 11 microsatellites from the Genethon map (D1S472, D1S2722, D1S211, D1S197, D1S231, D1S2661; D1S417, D1S475, D1S200, D1S2742, D1S2890) as reported (Collod et al, 1994).

[0144] Linkage Analysis

[0145] Parametric linkage analyses were performed with accepted parameters of ADH: dominant transmission of the trait, penetrance of 0.9 for heterozygotes, and a frequency of the disease allele of 1/500. The MLINK and LINKMAP programs (Ott, 1991), and the VITESSE program (O'Connell & Weeks, 1995) were used to perform the two-point and multipoint LOD score analyses. Microsatellite allele frequencies were calculated among the unrelated family members. Linkage was investigated with the assumption of equal female-to-male recombination rates.

[0146] Candidate Gene Identification and Analysis

[0147] Microsatellites of the 1p34-p32 region were localized on sequences of the Human Genome Project, a physical map of the region was in agreement with the one published by UCSC: http://www.genome.ucsc.edu. Repeat Masker and Genscan programs allowed the prediction and the identification in the Genbank database of positional candidate genes. The Blast program (http://www.ncbi.nlm.nih.gov/BLAST/) was used to localize precisely the candidate genes. The intron/exon structure of the 8 finctional candidates was determined and primers designed with the Mac Vector® software. 137 primer pairs were chosen at approximatively 100 bp surrounding each exon boundary. PCRs were performed with thermostable DNA polymerase from LAROVA Biochemic GmbH (Germany) on GeneAmp® PCR system 9600 (Perkin Elmer). Fluorescent sequencing was carried-out with Big Dye Terminator version 1.0 on GeneAmp® PCR system 9700 (Perkin Elmer) apparatus, under conditions supplied by the manufacturer. Electrophoregrams were analyzed using Sequencing Analysis®3.4 and SeqED®.

[0148] PCSK9 Analysis

[0149] Primers designed to study the 12 exons of NARC-1, and their conditions of amplification are available on request. Major rearrangements for NARC-1 were investigated by Southern blot as reported (Collot et al, 1994). A rapid detection method of the S127R mutation using PCR amplification followed by digestion by Mnll was developped. After amplification of exon 2, the 543 bp PCR product was digested by 5U MnlI enzyme. After electrophoresis on a 2% agarose gel, fragments of 208, 203 and 60 bp were distinguished in the normal allele, while fragments of 208, 143 and 60 bp appeared in the mutated alleles (the 203 bp normal fragment was divided in fragments of 143 and 60 bp and the two 60 bp fragments generated comigrated). Segregation analysis of this mutation in families HC2 and HC92 and analysis of 200 chromosomes from unaffected persons of French descent were tested both by sequencing and by the Mnll -digestion.

[0150] NARC-1 Mutants and Protein Studies

[0151] HEK293 cells were transiently transfected with pIRES2 recombinant vectors (Seidah et al, 2003) expressing wild type hNARC-1-V5 (WT) or its mutants H226A, F216L, S127R, S127A, S127P and 15_(—)16insL (+L). 24h later the cells were pulse-labeled with [³⁵S] EasyTag Express mix for 4h. Cell extracts and media were immunoprecipitated with a V5 antibody and the precipitates resolved by SDS-PAGE on an 8% Glycine gels.

[0152] Accession Numbers for the Genes Tested

[0153] EPS15, NM₁₃ 001981; OSBPL9, NM_(—)024586; SCP2, NM_(—)002979; LRP8, NM_(—)004631; DHCR24, NM_(—)014762; PRKAA2, NM_(—)006252; DABI, NM_(—)021080); NARC-1: human AX207686 (gi:15422368); Mus musculus: AX207688; Rattus norvegicus AX207690.

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[0195] TABLE 1 Regional lod scores obtained in the HC92 family LOD score at θ Locus Distance¹ 0.00 0.001 0.01 0.05 0.10 0.20 0.30 0.40 Z_(max) θ_(max) D1S2722 . . . 2.17 2.17 2.13 1.96 1.75 1.31 0.87 0.44 2.17 0.00 D1S211 0.025 −0.77 1.53 2.46 2.86 2.77 2.22 1.48 0.67 2.86 0.05 D1S197 0.063 −1.73 −1.72 −1.62 −1.20 −0.86 −0.48 −0.26 −0.11 −0.11 0.40 D1S231 0.014 1.08 1.08 1.08 1.06 1.00 0.81 0.57 0.30 1.08 0.00 D1S417 0.036 3.12 3.11 3.08 2.89 2.61 1.93 1.16 0.43 3.12 0.00 D1S200 0.007 2.50 2.49 2.45 2.25 1.98 1.44 0.87 0.33 2.50 0.00 D1S2742 0.007 4.26 4.26 4.21 3.97 3.61 2.67 1.79 0.77 4.26 0.00 D1S2890 0.013 0.84 1.29 2.08 2.54 2.52 2.05 1.35 0.58 2.54 0.05

[0196] TABLE 2 Polymorphisms identified in the PCSK9 gene Position Polymorp. Nucleotidic SEQ ID Amino acid Nb of indiv. Exon Name Variation N^(o)3 variation tested Frequency 1 A C→T  916 5′UTR 113 0.119 B Leu stretch 1022-1042 15_16insL 113 0.168 insCTG (+L) C G→T  1116 R46L 113 0.022 D C→T  1120 S47S 113 0.016 E C→T  1137 A53V 113 0.124 2 F T→C  4824 Intronic 100 0.040 3 G G→A  7464 Intronic 25 0.016 4 H G→C 13327 Intronic 100 0.548 I G→C 13349 Intronic 100 0.547 J G→A 13406 Intronic 100 0.063 K G→A 13559 Intronic 100 0.052 L C→A 13626 Intronic 100 0.076 M A→G 13632 Intronic 100 0.382 5 N G→A 13753 Intronic 23 0.020 O C→T 13781 Intronic 23 0.280 P A→G 13932 Intronic 23 0.240 Q A→C 13993 Intronic 23 0.170 8 R T→C 19444 Intronic 20 0.175 9 S T→C 19576 Intronic 113 0.137 T G→A 19657 V460V 113 0.128 U A→G 19697 I474V 113 0.141 10 V C→T 20845 Intronic 24 0.040 W A→G 20846 Intronic 24 0.146 11 X A→G 22769 Intronic 20 0.030 12 Y A→G 24633 E670G 79 0.082

[0197] TABLE 3 Haplotypes of affected subjects from the three ADH families Markers in 1p32 region PCSK9 Exon 1 Exon 4 Exon 9 Family Mutation D1S417 Polym. B Polym. H Polym. I Polym. M Polym. U D1S200 D1S2742 HC92 S127R 2 No G G A A 3 6 HC2 S127R 2 No G G A A 3 6 HC60 F216L 4 No C C G G — 3

[0198] Marker haplotypes surrounding the mutations of PCSK9: markers are given in physical order from telomere (left) to centromere (right). A common disease haplotype segregates with the S127R mutation in both the HC92 and the HC2 family. TABLE 4 Mutations identified in the PCSK9 gene Nucleotidic Position Amino acid Exon Variation SEQ ID N^(o)1 variation Effect 1 +CTA  314-316 Insert L23 1 +CTACTA  314-319 Insert LL23, 24 1 CAG→GAG  335-337 Q31N 1 TGC→GCA  443-445 C67A 2 ACC→GCC  473-475 T77A 2 TAC→GCC  476-478 Y78A Inactive zymogen 2 GTG→GCG  479-481 V79A 2 GTG→GCG  482-484 V80A Inactive zymogen 2 GTG→ATT  482-484 V80I 2 GTG→GCG  482-484 V80A 2 GTG→TTG  482-484 V80L Inactive zymogen 2 GTG→GCG  485-487 V81A 2 CTG→GCG  488-490 L82A Inactive zymogen 2 CTG→GTG  488-490 L82V Partially active enzyme 2 CTG→CCG  488-490 L82P Inactive zymogen 2 GTGGTGGTG→  485-490 V79R & V80R Inactive zymogen CGGCGGCTG & V81L 2 GTG→ATT &  479-481 & V79I & K83M Increased zymogen AAG→ATG  491-493 activation 2 GAG→GCG  494-496 E84A None 2 GAG→GCG  497-499 E85A 2 ACC→GCC  500-502 T86A 2 CAC→GCC  503-505 H87A 2 CTC→GCC  506-508 L88A 2 GCTGCC→CGTAGA  548-553 A102R & Inactive zymogen A103R 2 ACC→ATC  569-571 T109I Increased zymogen activation 2 GTG→ATT &  479-481 & V79I & K83M Inactive zymogen AAG→ATG &  491-493 & & CTG→CCG  578-580 L112P 2 ATG→GCG  620-622 M126A Decreased zymogen activation 2 AGT→CGT  623-625 S127R Decreased zymogen activation 2 AGT→GCT  623-625 S127A Decreased zymogen activation 2 AGT→CCT  623-625 S127P None 3 CCC→TAC  656-658 P138Y Decreased zymogen activation 3 ATC→CCC  671-673 I143P Inactive zymogen 4 TTC→CTC  890-892 F216L 4 AGA→AGT  896-898 R218S 5 CAT→GCT  920-922 H226A Inactive zymogen 5 CGC→TGG  953-955 R237W 6 AAC→GCA 1193-1195 N317A Inactive zymogen 10 AAC→GCG/GCA/GCC/ 1841-1843 N533A GCT 10 AAC→CAG 1841-1843 N533Q Loss of N-glycosylation 11 AAC→CAG 2000-2002 N586Q 12 AAC→CAG 2198-2200 N652Q

[0199]

1 3 1 3617 DNA Homo sapiens CDS (245)..(2320) 1 cccacgcgtc cggcctggag gagtgagcca ggcagtgaga ctggctcggg cgggccggga 60 cgcgtcgttg cagcagcggc tcccagctcc cagccaggat tccgcgcgcc ccttcacgcg 120 ccctgctcct gaacttcagc tcctgcacag tcctccccac cgcaaggctc aaggcgccgc 180 cggcgtggac cgcgcacggc ctctaggtct cctcgccagg acagcaacct ctcccctggc 240 cctc atg ggc acc gtc agc tcc agg cgg tcc tgg tgg ccg ctg cca ctg 289 Met Gly Thr Val Ser Ser Arg Arg Ser Trp Trp Pro Leu Pro Leu 1 5 10 15 ctg ctg ctg ctg ctg ctg ctc ctg ggt ccc gcg ggc gcc cgt gcg cag 337 Leu Leu Leu Leu Leu Leu Leu Leu Gly Pro Ala Gly Ala Arg Ala Gln 20 25 30 gag gac gag gac ggc gac tac gag gag ctg gtg cta gcc ttg cgt tcc 385 Glu Asp Glu Asp Gly Asp Tyr Glu Glu Leu Val Leu Ala Leu Arg Ser 35 40 45 gag gag gac ggc ctg gcc gaa gca ccc gag cac gga acc aca gcc acc 433 Glu Glu Asp Gly Leu Ala Glu Ala Pro Glu His Gly Thr Thr Ala Thr 50 55 60 ttc cac cgc tgc gcc aag gat ccg tgg agg ttg cct ggc acc tac gtg 481 Phe His Arg Cys Ala Lys Asp Pro Trp Arg Leu Pro Gly Thr Tyr Val 65 70 75 gtg gtg ctg aag gag gag acc cac ctc tcg cag tca gag cgc act gcc 529 Val Val Leu Lys Glu Glu Thr His Leu Ser Gln Ser Glu Arg Thr Ala 80 85 90 95 cgc cgc ctg cag gcc cag gct gcc cgc cgg gga tac ctc acc aag atc 577 Arg Arg Leu Gln Ala Gln Ala Ala Arg Arg Gly Tyr Leu Thr Lys Ile 100 105 110 ctg cat gtc ttc cat ggc ctt ctt cct ggc ttc ctg gtg aag atg agt 625 Leu His Val Phe His Gly Leu Leu Pro Gly Phe Leu Val Lys Met Ser 115 120 125 ggc gac ctg ctg gag ctg gcc ttg aag ttg ccc cat gtc gac tac atc 673 Gly Asp Leu Leu Glu Leu Ala Leu Lys Leu Pro His Val Asp Tyr Ile 130 135 140 gag gag gac tcc tct gtc ttt gcc cag agc atc ccg tgg aac ctg gag 721 Glu Glu Asp Ser Ser Val Phe Ala Gln Ser Ile Pro Trp Asn Leu Glu 145 150 155 cgg att acc cct cca cgg tac cgg gcg gat gaa tac cag ccc ccc gac 769 Arg Ile Thr Pro Pro Arg Tyr Arg Ala Asp Glu Tyr Gln Pro Pro Asp 160 165 170 175 gga ggc agc ctg gtg gag gtg tat ctc cta gac acc agc ata cag agt 817 Gly Gly Ser Leu Val Glu Val Tyr Leu Leu Asp Thr Ser Ile Gln Ser 180 185 190 gac cac cgg gaa atc gag ggc agg gtc atg gtc acc gac ttc gag aat 865 Asp His Arg Glu Ile Glu Gly Arg Val Met Val Thr Asp Phe Glu Asn 195 200 205 gtg ccc gag gag gac ggg acc cgc ttc cac aga cag gcc agc aag tgt 913 Val Pro Glu Glu Asp Gly Thr Arg Phe His Arg Gln Ala Ser Lys Cys 210 215 220 gac agt cat ggc acc cac ctg gca ggg gtg gtc agc ggc cgg gat gcc 961 Asp Ser His Gly Thr His Leu Ala Gly Val Val Ser Gly Arg Asp Ala 225 230 235 ggc gtg gcc aag ggt gcc agc atg cgc agc ctg cgc gtg ctc aac tgc 1009 Gly Val Ala Lys Gly Ala Ser Met Arg Ser Leu Arg Val Leu Asn Cys 240 245 250 255 caa ggg aag ggc acg gtt agc ggc acc ctc ata ggc ctg gag ttt att 1057 Gln Gly Lys Gly Thr Val Ser Gly Thr Leu Ile Gly Leu Glu Phe Ile 260 265 270 cgg aaa agc cag ctg gtc cag cct gtg ggg cca ctg gtg gtg ctg ctg 1105 Arg Lys Ser Gln Leu Val Gln Pro Val Gly Pro Leu Val Val Leu Leu 275 280 285 ccc ctg gcg ggt ggg tac agc cgc gtc ctc aac gcc gcc tgc cag cgc 1153 Pro Leu Ala Gly Gly Tyr Ser Arg Val Leu Asn Ala Ala Cys Gln Arg 290 295 300 ctg gcg agg gct ggg gtc gtg ctg gtc acc gct gcc ggc aac ttc cgg 1201 Leu Ala Arg Ala Gly Val Val Leu Val Thr Ala Ala Gly Asn Phe Arg 305 310 315 gac gat gcc tgc ctc tac tcc cca gcc tca gct ccc gag gtc atc aca 1249 Asp Asp Ala Cys Leu Tyr Ser Pro Ala Ser Ala Pro Glu Val Ile Thr 320 325 330 335 gtt ggg gcc acc aat gcc cag gac cag ccg gtg acc ctg ggg act ttg 1297 Val Gly Ala Thr Asn Ala Gln Asp Gln Pro Val Thr Leu Gly Thr Leu 340 345 350 ggg acc aac ttt ggc cgc tgt gtg gac ctc ttt gcc cca ggg gag gac 1345 Gly Thr Asn Phe Gly Arg Cys Val Asp Leu Phe Ala Pro Gly Glu Asp 355 360 365 atc att ggt gcc tcc agc gac tgc agc acc tgc ttt gtg tca cag agt 1393 Ile Ile Gly Ala Ser Ser Asp Cys Ser Thr Cys Phe Val Ser Gln Ser 370 375 380 ggg aca tca cag gct gct gcc cac gtg gct ggc att gca gcc atg atg 1441 Gly Thr Ser Gln Ala Ala Ala His Val Ala Gly Ile Ala Ala Met Met 385 390 395 ctg tct gcc gag ccg gag ctc acc ctg gcc gag ttg agg cag aga ctg 1489 Leu Ser Ala Glu Pro Glu Leu Thr Leu Ala Glu Leu Arg Gln Arg Leu 400 405 410 415 atc cac ttc tct gcc aaa gat gtc atc aat gag gcc tgg ttc cct gag 1537 Ile His Phe Ser Ala Lys Asp Val Ile Asn Glu Ala Trp Phe Pro Glu 420 425 430 gac cag cgg gta ctg acc ccc aac ctg gtg gcc gcc ctg ccc ccc agc 1585 Asp Gln Arg Val Leu Thr Pro Asn Leu Val Ala Ala Leu Pro Pro Ser 435 440 445 acc cat ggg gca ggt tgg cag ctg ttt tgc agg act gtg tgg tca gca 1633 Thr His Gly Ala Gly Trp Gln Leu Phe Cys Arg Thr Val Trp Ser Ala 450 455 460 cac tcg ggg cct aca cgg atg gcc aca gcc atc gcc cgc tgc gcc cca 1681 His Ser Gly Pro Thr Arg Met Ala Thr Ala Ile Ala Arg Cys Ala Pro 465 470 475 gat gag gag ctg ctg agc tgc tcc agt ttc tcc agg agt ggg aag cgg 1729 Asp Glu Glu Leu Leu Ser Cys Ser Ser Phe Ser Arg Ser Gly Lys Arg 480 485 490 495 cgg ggc gag cgc atg gag gcc caa ggg ggc aag ctg gtc tgc cgg gcc 1777 Arg Gly Glu Arg Met Glu Ala Gln Gly Gly Lys Leu Val Cys Arg Ala 500 505 510 cac aac gct ttt ggg ggt gag ggt gtc tac gcc att gcc agg tgc tgc 1825 His Asn Ala Phe Gly Gly Glu Gly Val Tyr Ala Ile Ala Arg Cys Cys 515 520 525 ctg cta ccc cag gcc aac tgc agc gtc cac aca gct cca cca gct gag 1873 Leu Leu Pro Gln Ala Asn Cys Ser Val His Thr Ala Pro Pro Ala Glu 530 535 540 gcc agc atg ggg acc cgt gtc cac tgc cac caa cag ggc cac gtc ctc 1921 Ala Ser Met Gly Thr Arg Val His Cys His Gln Gln Gly His Val Leu 545 550 555 aca ggc tgc agc tcc cac tgg gag gtg gag gac ctt ggc acc cac aag 1969 Thr Gly Cys Ser Ser His Trp Glu Val Glu Asp Leu Gly Thr His Lys 560 565 570 575 ccg cct gtg ctg agg cca cga ggt cag ccc aac cag tgc gtg ggc cac 2017 Pro Pro Val Leu Arg Pro Arg Gly Gln Pro Asn Gln Cys Val Gly His 580 585 590 agg gag gcc agc atc cac gct tcc tgc tgc cat gcc cca ggt ctg gaa 2065 Arg Glu Ala Ser Ile His Ala Ser Cys Cys His Ala Pro Gly Leu Glu 595 600 605 tgc aaa gtc aag gag cat gga atc ccg gcc cct cag gag cag gtg acc 2113 Cys Lys Val Lys Glu His Gly Ile Pro Ala Pro Gln Glu Gln Val Thr 610 615 620 gtg gcc tgc gag gag ggc tgg acc ctg act ggc tgc agt gcc ctc cct 2161 Val Ala Cys Glu Glu Gly Trp Thr Leu Thr Gly Cys Ser Ala Leu Pro 625 630 635 ggg acc tcc cac gtc ctg ggg gcc tac gcc gta gac aac acg tgt gta 2209 Gly Thr Ser His Val Leu Gly Ala Tyr Ala Val Asp Asn Thr Cys Val 640 645 650 655 gtc agg agc cgg gac gtc agc act aca ggc agc acc agc gaa gag gcc 2257 Val Arg Ser Arg Asp Val Ser Thr Thr Gly Ser Thr Ser Glu Glu Ala 660 665 670 gtg aca gcc gtt gcc atc tgc tgc cgg agc cgg cac ctg gcg cag gcc 2305 Val Thr Ala Val Ala Ile Cys Cys Arg Ser Arg His Leu Ala Gln Ala 675 680 685 tcc cag gag ctc cag tgacagcccc atcccaggat gggtgtctgg ggagggtcaa 2360 Ser Gln Glu Leu Gln 690 gggctggggc tgagctttaa aatggttccg acttgtccct ctctcagccc tccatggcct 2420 ggcacgaggg gatggggatg cttccgcctt tccggggctg ctggcctggc ccttgagtgg 2480 ggcagcctcc ttgcctggaa ctcactcact ctgggtgcct cctccccagg tggaggtgcc 2540 aggaagctcc ctccctcact gtggggcatt tcaccattca aacaggtcga gctgtgctcg 2600 ggtgctgcca gctgctccca atgtgccgat gtccgtgggc agaatgactt ttattgagct 2660 cttgttccgt gccaggcatt caatcctcag gtctccacca aggaggcagg attcttccca 2720 tggatagggg agggggcggt aggggctgca gggacaaaca tcgttggggg gtgagtgtga 2780 aaggtgctga tggccctcat ctccagctaa ctgtggagaa gcccctgggg gctccctgat 2840 taatggaggc ttagctttct ggatggcatc tagccagagg ctggagacag gtgtgcccct 2900 ggtggtcaca ggctgtgcct tggtttcctg agccaccttt actctgctct atgccaggct 2960 gtgctagcaa cacccaaagg tggcctgcgg ggagccatca cctaggactg actcggcagt 3020 gtgcagtggt gcatgcactg tctcagccaa cccgctccac tacccggcag ggtacacatt 3080 cgcaccccta cttcacagag gaagaaacct ggaaccagag ggggcgtgcc tgccaagctc 3140 acacagcagg aactgagcca gaaacgcaga ttgggctggc tctgaagcca agcctcttct 3200 tacttcaccc ggctgggctc ctcattttta cgggtaacag tgaggctggg aaggggaaca 3260 cagaccagga agctcggtga gtgatggcag aacgatgcct gcaggcatgg aactttttcc 3320 gttatcaccc aggcctgatt cactggcctg gcggagatgc ttctaaggca tggtcggggg 3380 agagggccaa caactgtccc tccttgagca ccagccccac ccaagcaagc agacatttat 3440 cttttgggtc tgtcctctct gttgcctttt tacagccaac ttttctagac ctgttttgct 3500 tttgtaactt gaagatattt attctgggtt ttgtagcatt tttattaata tggtgacttt 3560 ttaaaataaa aacaaacaaa cgttgtccta aaaaaaaaaa aaaaaawaaa aaaaaaa 3617 2 692 PRT Homo sapiens ACT_SITE (186)..(186) Asp 2 Met Gly Thr Val Ser Ser Arg Arg Ser Trp Trp Pro Leu Pro Leu Leu 1 5 10 15 Leu Leu Leu Leu Leu Leu Leu Gly Pro Ala Gly Ala Arg Ala Gln Glu 20 25 30 Asp Glu Asp Gly Asp Tyr Glu Glu Leu Val Leu Ala Leu Xaa Ser Glu 35 40 45 Glu Asp Gly Leu Xaa Glu Ala Pro Glu His Gly Thr Thr Ala Thr Phe 50 55 60 His Arg Cys Ala Lys Asp Pro Trp Arg Leu Pro Gly Thr Tyr Val Val 65 70 75 80 Val Leu Lys Glu Glu Thr His Leu Ser Gln Ser Glu Arg Thr Ala Arg 85 90 95 Arg Leu Gln Ala Gln Ala Ala Arg Arg Gly Tyr Leu Thr Lys Ile Leu 100 105 110 His Val Phe His Gly Leu Leu Pro Gly Phe Leu Val Lys Met Xaa Gly 115 120 125 Asp Leu Leu Glu Leu Ala Leu Lys Leu Pro His Val Asp Tyr Ile Glu 130 135 140 Glu Asp Ser Ser Val Phe Ala Gln Ser Ile Pro Trp Asn Leu Glu Arg 145 150 155 160 Ile Thr Pro Pro Arg Tyr Arg Ala Asp Glu Tyr Gln Pro Pro Asp Gly 165 170 175 Gly Ser Leu Val Glu Val Tyr Leu Leu Asp Thr Ser Ile Gln Ser Asp 180 185 190 His Arg Glu Ile Glu Gly Arg Val Met Val Thr Asp Phe Glu Asn Val 195 200 205 Pro Glu Glu Asp Gly Thr Arg Xaa His Arg Gln Ala Ser Lys Cys Asp 210 215 220 Ser His Gly Thr His Leu Ala Gly Val Val Ser Gly Arg Asp Ala Gly 225 230 235 240 Val Ala Lys Gly Ala Ser Met Arg Ser Leu Arg Val Leu Asn Cys Gln 245 250 255 Gly Lys Gly Thr Val Ser Gly Thr Leu Ile Gly Leu Glu Phe Ile Arg 260 265 270 Lys Ser Gln Leu Val Gln Pro Val Gly Pro Leu Val Val Leu Leu Pro 275 280 285 Leu Ala Gly Gly Tyr Ser Arg Val Leu Asn Ala Ala Cys Gln Arg Leu 290 295 300 Ala Arg Ala Gly Val Val Leu Val Thr Ala Ala Gly Asn Phe Arg Asp 305 310 315 320 Asp Ala Cys Leu Tyr Ser Pro Ala Ser Ala Pro Glu Val Ile Thr Val 325 330 335 Gly Ala Thr Asn Ala Gln Asp Gln Pro Val Thr Leu Gly Thr Leu Gly 340 345 350 Thr Asn Phe Gly Arg Cys Val Asp Leu Phe Ala Pro Gly Glu Asp Ile 355 360 365 Ile Gly Ala Ser Ser Asp Cys Ser Thr Cys Phe Val Ser Gln Ser Gly 370 375 380 Thr Ser Gln Ala Ala Ala His Val Ala Gly Ile Ala Ala Met Met Leu 385 390 395 400 Ser Ala Glu Pro Glu Leu Thr Leu Ala Glu Leu Arg Gln Arg Leu Ile 405 410 415 His Phe Ser Ala Lys Asp Val Ile Asn Glu Ala Trp Phe Pro Glu Asp 420 425 430 Gln Arg Val Leu Thr Pro Asn Leu Val Ala Ala Leu Pro Pro Ser Thr 435 440 445 His Gly Ala Gly Trp Gln Leu Phe Cys Arg Thr Val Trp Ser Ala His 450 455 460 Ser Gly Pro Thr Arg Met Ala Thr Ala Xaa Ala Arg Cys Ala Pro Asp 465 470 475 480 Glu Glu Leu Leu Ser Cys Ser Ser Phe Ser Arg Ser Gly Lys Arg Arg 485 490 495 Gly Glu Arg Met Glu Ala Gln Gly Gly Lys Leu Val Cys Arg Ala His 500 505 510 Asn Ala Phe Gly Gly Glu Gly Val Tyr Ala Ile Ala Arg Cys Cys Leu 515 520 525 Leu Pro Gln Ala Asn Cys Ser Val His Thr Ala Pro Pro Ala Glu Ala 530 535 540 Ser Met Gly Thr Arg Val His Cys His Gln Gln Gly His Val Leu Thr 545 550 555 560 Gly Cys Ser Ser His Trp Glu Val Glu Asp Leu Gly Thr His Lys Pro 565 570 575 Pro Val Leu Arg Pro Arg Gly Gln Pro Asn Gln Cys Val Gly His Arg 580 585 590 Glu Ala Ser Ile His Ala Ser Cys Cys His Ala Pro Gly Leu Glu Cys 595 600 605 Lys Val Lys Glu His Gly Ile Pro Ala Pro Gln Glu Gln Val Thr Val 610 615 620 Ala Cys Glu Glu Gly Trp Thr Leu Thr Gly Cys Ser Ala Leu Pro Gly 625 630 635 640 Thr Ser His Val Leu Gly Ala Tyr Ala Val Asp Asn Thr Cys Val Val 645 650 655 Arg Ser Arg Asp Val Ser Thr Thr Gly Ser Thr Ser Glu Xaa Ala Val 660 665 670 Thr Ala Val Ala Ile Cys Cys Arg Ser Arg His Leu Ala Gln Ala Ser 675 680 685 Gln Glu Leu Gln 690 3 26220 DNA Homo sapiens exon (980)..(1186) exon 1 3 ctggatgctt gtccagttga tttcttgaac atggtgtgta aaaggaatct ttgcaaattg 60 aatcttctgg aaagctgagc ttgtgcctac catagaattc tgaatgtacc tatatgacat 120 ctttgcaaac ttaaaacctg aatctttgta gtataaatcc cttgaaatgc atgtaggctg 180 gacatcaaaa gcaagcaatc tcttcaagga gcagctagtt ggtaaggtca gtgtgcaggg 240 tgcataaagg gcagaggccg gagggggtcc aggctaagtt tagaaggctg ccaggttaag 300 gccagtggaa agaattcggt gggcagcgag gagtccacag taggattgat tcagaagtct 360 cactggtcag caggagacaa ggtggaccca ggaaacactg aaaaggtggg cccggcagaa 420 cttggagtct ggcatcccac gcagggtgag aggcgggaga ggaggagccc ctagggcgcc 480 ggcctgcctt ccagcccagt taggatttgg gagttttttc ttccctctgc gcgtaatctg 540 acgctgtttg gggagggcga ggccgaaacc tgatcctcca gtccgggggt tccgttaatg 600 tttaatcaga taggatcgtc cgatggggct ctggtggcgt gatctgcgcg ccccaggcgt 660 caagcaccca caccctagaa ggtttccgca gcgacgtcga ggcgctcatg gttgcaggcg 720 ggcgccgccg ttcagttcag ggtctgagcc tggaggagtg agccaggcag tgagactggc 780 tcgggcgggc cgggacgcgt cgttgcagca gcggctccca gctcccagcc aggattccgc 840 gcgccccttc acgcgccctg ctcctgaact tcagctcctg cacagtcctc cccaccgcaa 900 ggctcaaggc gccgccggcg tggaccgcgc acggcctcta ggtctcctcg ccaggacagc 960 aacctctccc ctggccctc atg ggc acc gtc agc tcc agg cgg tcc tgg tgg 1012 Met Gly Thr Val Ser Ser Arg Arg Ser Trp Trp 1 5 10 ccg ctg cca ctg ctg ctg ctg ctg ctg ctg ctc ctg ggt ccc gcg ggc 1060 Pro Leu Pro Leu Leu Leu Leu Leu Leu Leu Leu Leu Gly Pro Ala Gly 15 20 25 gcc cgt gcg cag gag gac gag gac ggc gac tac gag gag ctg gtg cta 1108 Ala Arg Ala Gln Glu Asp Glu Asp Gly Asp Tyr Glu Glu Leu Val Leu 30 35 40 gcc ttg cgt tcc gag gag gac ggc ctg gcc gaa gca ccc gag cac gga 1156 Ala Leu Arg Ser Glu Glu Asp Gly Leu Ala Glu Ala Pro Glu His Gly 45 50 55 acc aca gcc acc ttc cac cgc tgc gcc aag gtgcgggtgt aggggtggga 1206 Thr Thr Ala Thr Phe His Arg Cys Ala Lys 60 65 ggccggggcg aacccgcagc cgggacggtg cggtgctgtt tcctctcggg cctcagtttc 1266 cccccatgta agagaggaag tggagtgcag gtcgccgagg gctcttcgct tggcacgatc 1326 ttgaggactg caggcaaggc ggcgggggag gacgggtagt ggggagcacg gtggagagcg 1386 gggacggccg gctctttggg gacttgctgg ggcgtgcggc tgcgctattc agtgggaagg 1446 ttcgcggggt tgggagaccc ggaggccgag gaagggcgag cagagcactg ccaggatatc 1506 ctgcccagat ttcccagttt ctgcctcgcc gcggcacagg tgggtgaagg agtgaatgcc 1566 tggaacgtac tgggaactgc accaggcaca gagaaagcgg gcttgccatt atagtgggtt 1626 ccgatttggt ttggaaaaca tgggcagcgg agggtggagg gcctggagag aaggccctac 1686 ccgagacagg ggcggggtgg gaaggacggc agatgctggg agcacgaggc aatttcttta 1746 tgacacagaa ctcatgctct agtattccat ctgtttcagc cgaagaaaag aaccagctga 1806 aggggcaggg gagaaggggc ggaggtattc tcgaggccca ttggcgtcct ttaggactca 1866 ggcagggaag ggcccttggt gctctggagc cggaggtggt gcgcctggta ctgggacccc 1926 ggagctgagc ccggcgcctc agcccacctg gctgtctgcc gaccgtgtgc ggggcgagtt 1986 tgctcaacaa ctctgccagc ttctggccct caggctgtgg gaagcttctt cccggggcga 2046 gaccactagc tttttctaag tattaccagc ccaggacttg gctgaggttc tgtgtccccc 2106 agcttggagt cagatgtggg gttgaatctt ggcttcctct cactagctgt ggtgcttgac 2166 aagtcactta tccttgagcc tccattgcct aatctttaaa agggaggtga caatcgtccc 2226 tacggctcag tggcagcaga tggggagatg aagggaaagt tctgttgacc atgagtgaac 2286 ttacaatgca agccccgggg ggatcacttg cagttttgtc cctgtctgca gtgtgacctg 2346 ttggtgacat tgtctttgct ccaaaccaca gctcctgggg cagaggggaa aattctgcca 2406 ctcacagctg cctgcccacg cttctgtctg agtgtgctgg gtggcaggat ggcaagtcct 2466 tactcagctc agtatagccc tcttccttgt tccctgagcc tttgactttc tcgagggatg 2526 ttgtggggtt gtggccagga taagaaaggg catttcaagt taccactgct ccaaaacaac 2586 tgttctggaa atagtgagta ccccatcctg agaggtgagt aagcagaggc tgtatgacca 2646 cctgaaccaa gcccttgagg atgtttcttc tctggtggaa gtttggaaca ggagcctcct 2706 caagttcatt tattcattca ttcaatggtt attttgtggg aatcgaattt agaatgaaaa 2766 tattttttgg caagcagaaa ataattttta gaccaatcct tttcttttag tcatgagaaa 2826 ctgaggccca gagagaggag gtcaccccag gtgcattaga actgggtttc cagaactgac 2886 actccactgc acagagtact ctcccaattc attcaatttt tatttagcgg aaggcatttt 2946 cagatgggtc tttgaagcat tagtaggagt tcagcgatga tggtgtcatg agaattttat 3006 tctaggatta ggaggtacca tgaacaaaga tacagagctg ggaaaaccag aggtggaaga 3066 taaggagcac atgtccacag ttctttttct tttttttttg agatggagtt tcgctcttgt 3126 tgcccaggct ggagtgcaat ggtgcagtct cagctcactg caacatctgt ctcccgggtt 3186 caagtggttc tcctgcctca gcctcccaag aagctgggat tacaggtacc tgccaccacg 3246 cccggctaat ttttgtattt ttagtagaga aggggtttca ccacgttggc caggctagtc 3306 gcaaactcct gacctcctca gtggatccga ggaggtgatc ctcccgcctc agcctcccaa 3366 agtgctcgaa ttacaggtgt gagccaccac gcctggcctc cacagttctt tatccaccgt 3426 ctgaaatgta aaatgttacg aaaaccaaaa gttttttttg tgatttattt gatggtagca 3486 cctgacgtga actgacatga gattattttt aatttagttg tgtgaatatg catattcata 3546 tattttgctg catagattac agtatgcagc tccagattct tccaagcaga ctctgattgc 3606 ccattactgc ctttctaaaa tccaaacaag ttctgaggtt caaaaccgat ttggccctaa 3666 ggctttgggt aaagggggtg gactctgttc tactctgact ggagtccaag atgcatatat 3726 acagagatat gggtgatggg gctgcaaggt aggttgaggt aggggccaag gaggagcatg 3786 gagtttggac ttgattcatg aggctgtggg gagccagtga aggttcttaa gcaggtatgt 3846 ctgcctgaga gcagttggag cagacaagag ctaaaaacca aacaaatcac catagatagt 3906 ggctgctata atttgtttgt cccctccaaa tctcatgtgg aaatttggtc ctcagtgttg 3966 gaagtggggc ctaatgggag gtgtttgggt catgggggag gaacccctgt gaaaggcttg 4026 gtgccgtcct tgtgataatg agtaagttct cccgctatga tttcccttga aggctgatta 4086 ttaaaaagag cttggcacct ccctctcttc tctcttgctt cttctcttgc catgtgattg 4146 atctctgcac atgtaggctc cccttcacct tctgccatca gtgaaagcag cttaaggccc 4206 tcaccagaag cagatgctgg tgccatgctt cctggagagc ttgcagaatc atgagctgaa 4266 taaatccctt ttccttgtaa attactcacc ttcaggtatt cctttatata gcaacacaaa 4326 aggactaaga cagtggcctt gacttttctc tctctttaag aagtgttgcc tttgctcact 4386 tagtcatccc ttctgcctgc atttgtagag catctggatg ggagatttat ataaccgtca 4446 ctcttgactt tcccagcagg cctatgtcat aggtactgtg gtctctacaa tacagcagag 4506 gtatctgagg ctccgagagg ttgagtgact tgctcatggc tgcacaacca gtaaatattg 4566 gagctggaat tcaggtccac ggtttcctgg ctccaaagcc catgattttt tccctcaatt 4626 tattctgact ggggcatggg ggagggggtg gcctttgggc agggccacca ggagcgacca 4686 ggcccgtaga gagctgggtg caggtacaga ggaaaacctg ttgtcgagtg tggcccgtag 4746 ttcccatttt tgcctgaatg gcacatttga aagtgttata taaccatgtg aataataata 4806 gttggcctat atgagttttt taatttgctt tttggtccgc atttggtaac ttctttatca 4866 tctactatac tctgttgtgt ctcttttgtt gtaatttgta agtaggggtg agataaagta 4926 cacctagggt ttgctgggtt tcttccatgt catcatgttc ctccttgcat ggggccag 4984 gat ccg tgg agg ttg cct ggc acc tac gtg gtg gtg ctg aag gag gag 5032 Asp Pro Trp Arg Leu Pro Gly Thr Tyr Val Val Val Leu Lys Glu Glu 70 75 80 85 acc cac ctc tcg cag tca gag cgc act gcc cgc cgc ctg cag gcc cag 5080 Thr His Leu Ser Gln Ser Glu Arg Thr Ala Arg Arg Leu Gln Ala Gln 90 95 100 gct gcc cgc cgg gga tac ctc acc aag atc ctg cat gtc ttc cat ggc 5128 Ala Ala Arg Arg Gly Tyr Leu Thr Lys Ile Leu His Val Phe His Gly 105 110 115 ctt ctt cct ggc ttc ctg gtg aag atg agt ggc gac ctg ctg gag ctg 5176 Leu Leu Pro Gly Phe Leu Val Lys Met Ser Gly Asp Leu Leu Glu Leu 120 125 130 gtgagccacc ctttttggga atggcacttc ctgatagggc tgggccactg catatacact 5236 ggggactgtg cttagtaggc ccattgctga aaatcagaag gggacagcaa gtatgtattg 5296 agcacttatc gggtaccaag cacagtaact actggctttc tgtatagaat tccctttaag 5356 cctggccatg ccccagtggt acgtctatct tcatttgaaa gacgaggaga ctgaagttca 5416 gaggggacca cacagacagc taggggtaga gcctggatca aacccattgg tctgcctgcc 5476 agccattctt gtgccaatgc atctgctgcc tacggaaacc tgtagggaca aggccctggg 5536 atgttcagtg gagcctgagt cattttataa aaaagcatga ctctagggtc caaaattcct 5596 ttgaagctgt tgctatccag agtgaagtcc cttctttagg acagggtggc cctcctccct 5656 cctggatgtc acatcttcgg tggaggggca gaaaggggac tgggtattct cctcaccctg 5716 gccctagtgc ttcaaatctt aaaaaaacgt ttttatttgt gcttctgcac caccttctag 5776 cccacctcgt ttcctggcct ctaacttgat gagagcgtgt gtcattttca cactgattct 5836 ccacatggca ggcggtgctt cttagcctcc tgcagacagt gaggccccac ggtcttgtcc 5896 aaggtcacac agcgtgtaat gggcagggtc agagtctgga gtctggacct gggtctccta 5956 gctgcactgc actgctgccc catgggttaa tcagctcagc ataccgtggc tgaacagcta 6016 cctcatacca aggcctgtgg cgccatgaca gggattgaca gggtccctgc cttggaaacc 6076 cgtagtctaa gtagaggaga ctgacaagtc aatgccttcc atcagtctgc tcaacacacg 6136 tttaccaagt gcctactgtg tgctgcagag gcgaagatga cacagctcag gcctttccct 6196 tgagcttaca gttcaggagg agagactgac cagtgactgc cagtacagtt gactatggga 6256 caatgtgctc agccttgggg agagacgaag aaggtacccg tatagcacca gatgacaggc 6316 acgagcccca caggccaggg cagctgctca gaggagagta ggccaagcag aaggcaaaca 6376 gaaggctgca ggcatttgcc atcgagagct ggacttcaaa ctgggcatca taccagcctg 6436 ggttcgagtc ctgcccagcc ccttattggc tgtctaaccc tgagcaaatc ccttcacctc 6496 tctgagcctc attcctctat ctgtaaacca gttataataa ttggaacatt catttaagga 6556 ctaaatgagg tcgtgaagca ttcagcagat gctaggtacg gaaactcgct gaagtggggg 6616 caggttaaga agcctctggg gatacgaagg catccaggga ctagttgtgg caggaggctg 6676 ttaccactta ggtctgaagg gtaaggagag ggaatagctt tccctctgcc cagttggagc 6736 cggtggcatg gaggagaggc tgcctgtggg gaatcacccg agggttcacc gctgccatgc 6796 gcagggagtc aggaggtagg gagggagtgg ggcagatgca caccattttt tttttttttt 6856 gagactctgt tgcccagact ggagtgcagt ggtgccatat ctgcacctct gcctcccggg 6916 ttcaagctca ctgcaacctc tgcctcccgg gttcaagcga ttctcctgcc tcagcctccc 6976 gagtagctgg gactacaggt gtgtgccacc atgcctggct aatttttgta tttttaatag 7036 agatggggtt tcaccatgtt ggccaggctg gtctcgaact ctcgacctca ggtgatcccc 7096 cacctcggcc tcccaaagtg ctgggattac aggcgtgagt caccgctccc agctgctgat 7156 gcactcttgt ccttctaact cctgctagtg cctcccattg gctgagccca actggaagct 7216 ttgcaaggga gctggtgctg cagtttgcac tgagcaggct ggagaaggct ggagaataga 7276 ctaggggaca aaccgaattg ccagtgctgt tatgtcatga tttaggcatg gagtccaggg 7336 cctgagcttc actccatgtc catcctgccc agagccttgg cacagcctgg ctcccagaca 7396 agatgtcaag ttcagaatcc ttcctaaaag gaatcctcta tgccagaccg tgttgcaggg 7456 atatgggggt gctgggctcc cagcctgatc aaggagcgag aaaactcagg ctcctagtct 7516 gtcctccggg gcactagcag ggacaaggtg ggaggctgct gggctgggat gtggggacag 7576 gtttgatcag gtaaggccag gctgtggctg tgtttgctgc tgtccaaatg gcttaagcag 7636 agtcccccgg cctctctggc ttctgcag gcc ttg aag ttg ccc cat gtc gac 7688 Ala Leu Lys Leu Pro His Val Asp 135 140 tac atc gag gag gac tcc tct gtc ttt gcc cag agc atc ccg tgg aac 7736 Tyr Ile Glu Glu Asp Ser Ser Val Phe Ala Gln Ser Ile Pro Trp Asn 145 150 155 ctg gag cgg att acc cct cca cgg tac cgg gcg gat gaa tac cag ccc 7784 Leu Glu Arg Ile Thr Pro Pro Arg Tyr Arg Ala Asp Glu Tyr Gln Pro 160 165 170 ccc g gtaagacccc catctgtgcc ctgccccacc ccatctgagc tgaatccatt 7838 Pro tgctctgccc tggcctggcc tccctgctgg tggtttccac ttctcggggg gctttgggac 7898 tcagcacctc cactgacccc tttttttctg tcccatcccc atcccctgca gcccccactg 7958 cctgccttcc tgttgcccca caaatgcaaa agtcttgcct taaatgatcc tcttttcctc 8018 cttttctctt gttttccttt tctcaccatt tggaatggcc cagcaggctg cacttacctt 8078 ggaaggaggg ttcatctgat ggtgactcta cctagggccc ccaggcctct ataactccca 8138 gtgccctgca gactggacca gatcctttaa tgggatagac acaaccctgt ctgggatgcc 8198 tctgcctacc ttcctgtttt gctgctccac ctgcctccag ctccgtttgg cttcctgggg 8258 ctccctgcct gggccacttt gtgtcttccc tctaggcctt tctttccact gttccctctg 8318 cctggtgtgg cctggctatg gaagggaggg agcaggagcg gccatggaaa acggtctgca 8378 ttctagcagg gacttgcagg tggcaattca gtcggggaag actctagatg cacctggcct 8438 gaggagagaa tgaagggttc tagttggact gtgttaagtt tgaggtgccc atggtgtgag 8498 gtctggagct cagcgcagag atgatgcaat gtggtgggtc catgcaacat ggtgccagga 8558 cgcagagctt ggggtgaact cagctttcac cccttaccgg ttctcgtggg atcttgggaa 8618 gccactttct tctatgagct ttgtcgttct tgtctgtaaa atgggcacat aaccctgtcc 8678 ctgtccttct cacaggttgc tgtgagactc caatgagttg aaggatgtgc agatgctttt 8738 ggaagtgaaa agttgggggg ctactgtgtg actttgcata cacccaaact gtgtgacctt 8798 gcatatgtct gagttgctgc cattgcaaca gatcagagct ggtgggctgg gtgtggagaa 8858 agggtttgtg tgggggacat cctctggcaa gggtggcagc agcagaagtg aggggcctgg 8918 tcggtcatgt gtgctgaccc ggcctgggca gcctgtggcc agggagagga cagctcctct 8978 gtaggaagag cgtgttcctt tccaaccagg tgagacctct tcagtggagc cctggagccc 9038 cctgtactcc acatcagtgc ctcagggacc tcccggagca ggctaatatc agagaccaag 9098 agggacactg gcagaggatc acagagaccc cagtccaggc agggactgag aagatcttgc 9158 cccctaagtt agtttcctag cactgctgtg acaaaatacc accccctcgg ttggaacaag 9218 ttgattctct gcagtcctgg aggccagaag cctgaatcag tgtcggcagg accactttct 9278 cccggggggc tccagggaga agcttctctt gcctcttccg tgtcccaaca gcggcagcac 9338 accaatccca gcctctgtct tcacacagcc ttctctgtgt ctctctcctc ttcattgtct 9398 cataaggaca cttgtcattg gatttagggc ccactggatc ctccaggatg atctcatgtg 9458 gggaacctta accacatctg caaggaccct ttttccaaat aaggtcacag ccacagtttg 9518 tgggggttag gatgtgagtg tatctctttg gcagccactg ttccctcctc tcccttgggc 9578 cagaagcaga cgtggggccc tttcttcccc ataggatgcc catggattgc cccccttccc 9638 gcttcccccg agcgtctgtg ggaggtggca ggaatggcag gcaggtgtgt ggaacccctt 9698 ctggagtcat atcaagggct tggctggagg aagtcctcct ggagctgttg ggctggcatg 9758 gggcaggctg gctgggccca gcagcagctt cttcattcat ggggaggcca caagcatggg 9818 ccctagagct ggctgccgcc ctcaaaccca gaccctgcac tcttaactgt gtgaccttgc 9878 atacgtcact caccctctct gatcttcagg ttcctctgca aaagggaggt aatgataacc 9938 ctcactctgg ggggctgttt ggagggttaa atcagttatt gctgtagcat gcatttctct 9998 gtcaggtatt gagtgaggtg ctgtgatttt agccctgcat ttttcttttc ttaccattca 10058 ataataacgt tttgagcacc ctctgtgcgc caggcaccat attaggtgct ggggatacaa 10118 atgtgaatga aatgaatgtg gtctctttcc ccaacagtgt atccagaaga ttaatccatt 10178 ccttaaacaa atgctacttg acacagatta gttctggata ggctgagagc tctgaaggag 10238 tgcaggcagc tgcgagcctg tgtatccagc agaaggatca ggaaaggatt cctggaggaa 10298 gcgctgttct agccaagacc tacgggggca ttattaacca ggcaaagggg acggtgtcca 10358 agcagtggaa tgaacgtgga ttgaagctgt gaggcaggag ggagtgtggc ctgtgcagaa 10418 gggaccgagg ctggtgagac cagcagggcc tgggtggcct ccaggtcaga tgtgaaagga 10478 agaacttggc cacagtctga gcttctcagg cgtatggcag ggctgcctgg tgagagggaa 10538 tgagctccct gctctggagg tatgcaagca ggactgggct ctcacctgcc agaggccaca 10598 gagctttcca gaggctggaa gaggccactc caaggcctct ttgcccctga gagtggtggc 10658 tcttcttgag gccaccttgc cacgctgtca cagggaacta gcagcccctg cctcacccgg 10718 gggtttggaa gatagaggga ggcctaggaa gggccctgtg tctcatccga gctgggcccc 10778 tttccagcct ctcactggaa ggaagcccaa ggatgttcct gtgggggctt ttaccaggcc 10838 cacctgccct ctgctggcca tgcttgcagc ctcctgaccc tgtcccagca ggacagtggg 10898 ctggtgtgag cgggcaggaa ccgcctgcac ttagaaggtg tggggctgcc tccccgagct 10958 tccatctgcc gctggggcca caccccaggc ccagggatgg gaccccatag tggtcacatc 11018 atcttgcagc agaacccagg tacagctcct ggagcagatg gtggtcccaa gcacgggtgg 11078 gaccagaaag gactctcacc tgggctaact cagctgcagc ctcagttccc tcctcacaca 11138 cgaggaacat ggactggaag cctgcccagc aggccttctg ctcgatgtgc gttgtgtggc 11198 ttacgtccag ggagggaagc agcctctgtg ctgtcttcta gataagcctg tattccccgg 11258 gctgtctgcc aatgtatcca gttgtcccgt cagcctggaa gctctgaggg aaaaccttgg 11318 gctgcttcct gagcacctgt atcccctgca gccagcccgg ggcctctgct aggagcagac 11378 tgagcatggc ttatgggcct ggcaccatct ggcctctgcc caccttgctg gccttgtctt 11438 gtgtctgccc cttcgacatt ccatagccca gctcaatatc tagtggttcc tctagggtgg 11498 cgagcactgt ttggtctcca gatgtcttca ggtcggagct cacagcgctc tcagccaccc 11558 cttcccagtg tagcaccggg cacatggtag atgcctattg atgagtgaaa gctcctaaca 11618 cactcagaga gcaaggactc cgcctcatcc cacagcctgg gaggagaggc agactgccaa 11678 ggacctgctc agcatgctac agaagaaacc aaagtgccca cgggactgat cagtggagct 11738 tcctgccgag actggaggcc ttagggcagg gtagacagtg tgtgtgcagg ctggggactc 11798 acagttcgga ctgtgcccag acctactagc atagtgggtg ggtgggagga tgcgggactg 11858 ggggccgacc ttgcctgaaa ttcatgtggg atctcagagc agccactgaa ttgctctgta 11918 gggggctaaa tagtggcccc cacagataca cacacccaga cagagcctgt gagccagacc 11978 ttatttggag aaaaggtctt tgtagatgta attaagcatc tcaagatggc atcatctgga 12038 ttatgcggtg ggctgtaagt cctgtgatgt gtctttatga gagaaaggca gagggagatt 12098 tgacacacac aggaggggcc acgtggagac agaggtggag attggagaaa tgtggccaca 12158 agccagggaa caccagcagc caccagaagc cggaagacgt gaggcagggt tcttcccaga 12218 gccttcgctg ctgagtctgg gaatttgtta ccgaagccat aagaagtggg tacacgccct 12278 gagcctccca cacttgctca cctgtcctga gatgagaatc tctactctgc agcatatttg 12338 gaggatcact gcgggggcca cagaggtgct gttcagatgg cacttcagaa gactcaggag 12398 accctggggc aggagcagtt tgactgacag cccagagggc tgccctctga ttccacctga 12458 ggccctgctt ttcctggctg caggggttcc agggccaggc catttccgct ggcgcaggac 12518 tctgctagca gcaacctgcc tgaagtcttc ctttggcctg gctgagagtt tctgagacct 12578 gcgctggagc ggaggtgctt ccttccttgc ttcctttctt cctctctccc ttctccatcc 12638 agcaggctgg acctgcctgg catctgtgag ctctccctac tttctcctat accctaacct 12698 ttgtcctgca tgggcgactc ccccagtgag tctcttgcag cttttacccc agtgcctgct 12758 tcttggagaa tccaaactga tccagttagg gatgataaag tgtagggtag gtgctcggtg 12818 actgttttct ctgaggttgt gactcgtgtg aggcagaagc agtccccgtg agccctcctg 12878 gtatcttgtg gagtggagaa cgcttggacc tggagccagg aggcccagac atacatcctg 12938 tccgagctgc agcttcctgt ctctaaaatg agccggccag cgcaggtggc cagacatcac 12998 tgttattctc ctttgagtct ttaaatcttg ttgtctttct tgcagactcg gtgagctgtg 13058 aaaggctata ataggggctt tattttacac tttgatacta ttttttgaac attcatatta 13118 ttgttagata ttgatattca tatgaaggag caggatgact tgggtccttc ttggcagtag 13178 cattgccagc tgatggcctt ggacagttac ctgccctctc taggcctccc tttccttgtc 13238 tatgaaatac attatagaat aggatgtagt gtgtgaggat tttttggagg ttaaacgagt 13298 gaatatattt aaggcgcttt caccagtggc tgggatgtgc tctgtagttt gtgtgtgtta 13358 actataaggt tgactttatg ctcattccct cctctcccac aaatgtcgcc ttggaaa 13415 gac gga ggc agc ctg gtg gag gtg tat ctc cta gac acc agc ata cag 13463 Asp Gly Gly Ser Leu Val Glu Val Tyr Leu Leu Asp Thr Ser Ile Gln 175 180 185 190 agt gac cac cgg gaa atc gag ggc agg gtc atg gtc acc gac ttc gag 13511 Ser Asp His Arg Glu Ile Glu Gly Arg Val Met Val Thr Asp Phe Glu 195 200 205 aat gtg ccc gag gag gac ggg acc cgc ttc cac aga cag gtaagcacgg 13560 Asn Val Pro Glu Glu Asp Gly Thr Arg Phe His Arg Gln 210 215 ccgtctgatg ggagggctgc ctctgcccat atccccatcc tggaggtggg tggggactgc 13620 caccccagag cattgcagct gtactcctgg gttgcacccc cccagctgtc actgtcccct 13680 ccctgccatc agttgtggga agggcgttca tccatccagc cacctgctga tttgttatag 13740 ggtggagggg gggtctttct catgtggtcc ttgtgttcgt cgagcag gcc agc aag 13796 Ala Ser Lys 220 tgt gac agt cat ggc acc cac ctg gca ggg gtg gtc agc ggc cgg gat 13844 Cys Asp Ser His Gly Thr His Leu Ala Gly Val Val Ser Gly Arg Asp 225 230 235 gcc ggc gtg gcc aag ggt gcc agc atg cgc agc ctg cgc gtg ctc aac 13892 Ala Gly Val Ala Lys Gly Ala Ser Met Arg Ser Leu Arg Val Leu Asn 240 245 250 tgc caa ggg aag ggc acg gtt agc ggc acc ctc ata g gtaagtgatg 13939 Cys Gln Gly Lys Gly Thr Val Ser Gly Thr Leu Ile 255 260 265 gccccagacg ctggtctctc tccatctgga cctggcctgg gaggtggctt gggatgggcc 13999 cagggagagc taatgtctcc taaccaagaa tgctgtggca gcctctgccg cagagccaga 14059 gaaccagagt gccaaggctg gcagggttcc cagtggccac gagtgcagat gaagaaaccc 14119 aggccccaag agggtcatgc aggtagccca gggagttcag ccttgaccct gggtcaatga 14179 cctttccaca gttccacact gctccccttt taaaatccgg tgatgtcttt atgtcttttg 14239 ttatgttatc ttcaatgtgg agggactcga ggtgatctaa gcaaactttt tctatcttct 14299 gcttgcatac ctctgagacc aggggactca ctcacttgca tgactgggcc ctgcaggtca 14359 cactggccag gcagatgtgg tggaggaact ggcagaggac tttttctaga ctgtgactac 14419 atttagtcca cccagcggcc cccctatgaa gtccagttga gaactaggac tctgggggcc 14479 tgtggacaga gaagagggag ggttctctcc cttactgact tccttctgtg gccagacatt 14539 gagcaaggcc tctgtacagc atgtcctggg gctggccttg ccgtagctgc taaatagttg 14599 acgaaaccag tccagagagg ggaggtgact gccagggtca cacagctcaa gctggggaac 14659 tcgctgggaa aactgtcagc tctgggcagc agcttgactt ccattgtaag ccccagcccc 14719 cagggtcaaa cactggctct ggtgctggca gaggcagccc actagcctgt ttcaaaggct 14779 gagaaggccc aggagtctgc cctgtgctcc accagttctg ccctgagact ttcctacaga 14839 gtacaggttt tgatgttcag ttttaaaggc aagaatcaat aaccttctgc cccatcaggt 14899 gaccccttgt gcctgtccca cccctttatt gactgacctc ggctcagtca ggtcagttcc 14959 tgaaggtcag tgtgtggagg ggaggctgtt ctttcccaga aaggccttcc ccaggcctgg 15019 tgctctggcc tctggaggac ttcctggaga agtcccttct ttggggtccc agtcagtgta 15079 tgggaagccc ttattgcatg acctggcacg gggtaggggc tcaacagtca ctattgcctt 15139 ccttgccact gccatttcct cctctgtaag caggtgattg tgtgtccagt ctgagcacag 15199 agataagcac acagcaggtg cttaataact agcagctgta ggctgggcgc ggtggctcat 15259 gcctgtaatc ccagcacttt gggaggccga ggtgggcaga tcacctgagg tcaggagttc 15319 gagaccagcc tgttcaacat ggtgaaaccc cgtctctact aaaaatacaa aaattagcca 15379 ggcatggtgg tgggtgtctg tatcccagct acttgggagg ctaaggcagg agaatcgctt 15439 gaacccagga ggtggaggtt gcagtgagct gagatcgtgc cactgcaatc cagcctgagt 15499 gatagagcga gattccatct caaaaataaa taagtaaata actagcagct gtaaatgtgg 15559 ctgttgttct tcacctccac actcagtgcc actccactcc ctccctccgt ggtgtgaggg 15619 gcctcactag ctgtctccta ggaggagcat ggctgtgaga ttccagctcc atccttgacc 15679 acggctcctg gagacatctt agaggccagg atccagaagg ctcccacacc ccatttgaca 15739 ggggagaagc tgtcagttcc aggtcccctt gcacatcagg gccagagctg cgttaggcct 15799 ccagtctcca ggccactggg ccagagctca caggctggca gagggttaga actgttactg 15859 gtggctgggt gcactggctc acgcctgtaa tcttagcact ttgggagggc aaggcgggag 15919 gatcatgagg tcaggacatc gagaccatcc ttgctaacac ggtgaagccc cgtctctact 15979 aaaactacaa aaaattagcc gggcgtggtg gcaggcgcct gtagtcccag ctactcagga 16039 ggctgaggca ggagaatggc gtgaacccgg gaggcggagc ttgcagtgag ccgagattgc 16099 gccactgcac tccagcctgg gcaatagagc gagactccgt ctggaaagaa aaaaaaaaaa 16159 agagctgtta ctgttgacag tagcatgagg tagaccatgg cctgcaccaa aagggggagt 16219 ggagtgccac tgaggccaga aggaaccaca ccctcaaggg tggggagtta tggtatgggg 16279 ggtcctaggc atggagtctt ttaattcttt agacaatcct gggagcagct gtccctgttt 16339 cacagagggc ggggccacac agctggtgag tgggcagcca agactctgtt caagtttgtg 16399 tgggtccaac acttgcggcc acggtggagg ggcatctgag ccaggcctca gagagtggcg 16459 gggggaagtt gggtggggaa gtgtgccctt ctcattcctc tgaggctcat cctcttggtg 16519 cctctctttc atggaaaggg ataataaggt tattgtgagg atcccctgag ttcatatatt 16579 cagacgctta gacagagcca ggcacagaga agggcccggg gttggctagt ttgattgctg 16639 gtgtaattgc taatatcttc cagtttgtat tggtcaaggt tctgcagaga agcagaacca 16699 gtaggaggta tatattaaga gtttcaagct catgtgaccg tgcgggctgg caagtctgaa 16759 atccgcaggg caggccatgc aggctggcaa ttcctgcaga atttgatgtt gcaatactga 16819 gtcctaaggc agtcctgggg cagaattcct tcttccctgg gaggcctcag tctgttctct 16879 taaggccttc aactgattaa atgaggcctg cccaagttat agagagtaac ctgccttact 16939 ccgtcttctg atttaaatgt tagtcacatc taaaaaatat tttcgcagca gcatttccac 16999 tggcttttga ccaaacatca ggccacaaag ttgatcccca aaattaacca tcactctgtg 17059 cctgtaaggg aggggctggg aaaggggagc aggtctcccc aaggggtgac cttggctttg 17119 ttcctcccag gc ctg gag ttt att cgg aaa agc cag ctg gtc cag cct 17167 Gly Leu Glu Phe Ile Arg Lys Ser Gln Leu Val Gln Pro 270 275 gtg ggg cca ctg gtg gtg ctg ctg ccc ctg gcg ggt ggg tac agc cgc 17215 Val Gly Pro Leu Val Val Leu Leu Pro Leu Ala Gly Gly Tyr Ser Arg 280 285 290 295 gtc ctc aac gcc gcc tgc cag cgc ctg gcg agg gct ggg gtc gtg ctg 17263 Val Leu Asn Ala Ala Cys Gln Arg Leu Ala Arg Ala Gly Val Val Leu 300 305 310 gtc acc gct gcc ggc aac ttc cgg gac gat gcc tgc ctc tac tcc cca 17311 Val Thr Ala Ala Gly Asn Phe Arg Asp Asp Ala Cys Leu Tyr Ser Pro 315 320 325 gcc tca gct ccc gag gtaggtgctg gggctgctgc cccaaggcgc gggtaggggg 17366 Ala Ser Ala Pro Glu 330 cggagggcgg agggagggcg ggcgggcagg cgggcttctt gtggcacgtg ggcttcttgt 17426 ggcacgttcc tggaggccga acccttctgg ctttggaagg agtcgtcaga gacccccgcc 17486 atgcgggagg ctggggagga aggggctcga aacctccatc atcgcagagt ctgaatagca 17546 gtggccccgc catgcgccca cgtagcggcg cctacgtagc cacgccccca cgccccgtcc 17606 tggccactct ccctcctgaa ggtcttctgg tacccgcccc ctccccatct ccatccccag 17666 gccctgcgtc ctctgcccaa tactctttgg gcctccctgt tgtccagctc tctccgcggc 17726 tccatgactg acaacttgag caaggctaat gtgaatggga gcggttgagg gctcagacct 17786 ctcacccgag gaacatccac agagtgtgcc gcatgcccgg tgcagtgtgg ctgcggggac 17846 acagacacgg agcctcggcc ctgaggagct ggggggcagt gaccgtccct cctctgaccc 17906 accactcctc cagtgtcagg acactgcggg tatctagggg aaggaatctt gttccacttc 17966 aagtctggaa cttcaagtct gtgtgtgtgc gtgcgcgcgc gcgcgttggg ggtgggggtt 18026 gcagagcaga tgcgtacctg acagcggtaa cctaggtccc cccggcctat caaggcttcc 18086 ctggcggccg aatttaaagg catcaagcaa acaaagccca acacatctct gccttgtcct 18146 ctcagtttcc ccccgtggca cttagaacca cttgatacac cgaatagttt ccggtctatc 18206 tcccccacta ggatgtaaac tccacagggg cattgggaat gctgcctggc tatggtaggg 18266 acagagggga gcaccagggc ggggcagggg tgccagagtt ctgcctgggc agtcagattt 18326 tccttaggag gggacatttg agtgggaccc aaacaggtgt atagcagttg tccagcccag 18386 ctggcaaggc ctgagtctgc ctctgcaacc cctctcttgg gctcctttct ctgccaccca 18446 cctcctcacc tttccag gtc atc aca gtt ggg gcc acc aat gcc cag gac 18496 Val Ile Thr Val Gly Ala Thr Asn Ala Gln Asp 335 340 cag ccg gtg acc ctg ggg act ttg ggg acc aac ttt ggc cgc tgt gtg 18544 Gln Pro Val Thr Leu Gly Thr Leu Gly Thr Asn Phe Gly Arg Cys Val 345 350 355 gac ctc ttt gcc cca ggg gag gac atc att ggt gcc tcc agc gac tgc 18592 Asp Leu Phe Ala Pro Gly Glu Asp Ile Ile Gly Ala Ser Ser Asp Cys 360 365 370 375 agc acc tgc ttt gtg tca cag agt ggg aca tca cag gct gct gcc cac 18640 Ser Thr Cys Phe Val Ser Gln Ser Gly Thr Ser Gln Ala Ala Ala His 380 385 390 gtg gct g gtaagtcacc accccactgc ctcggccacc gtgatgctaa cagccccttt 18697 Val Ala ggcagtcagg gtctgtgccg ggacctccag tgccaggctc tgtgcagggg gaccagagat 18757 gaagtaggcc tgatggtgcc ttcaaggaca ctcagtctga tgagggaggc gagtgcacag 18817 agggaacacg aggtcagggc tgtattagag ggagcccaga ggaggcacct gcccagcccg 18877 agggtcagag aaggcatctt ggaggaggga catttgatcg ggagcttgat ggatgaatag 18937 gagtttacct ggccgataag acagcaacta ccaaggctta gaggtgtgag aggaggctgt 18997 cttacctcac tgagtaagga ctgcaggcgg cttaccttcg agaagagagc ttagtgtctg 19057 tgtgcacgtg tgtttgtgtg tatgtgtgtg cgtgtgtgca ctggcaggag tcccctgctg 19117 gggcaggagg gccgggccat caccatcttt caccattcac ccctgcacca ggc att 19173 Gly Ile 395 gca gcc atg atg ctg tct gcc gag ccg gag ctc acc ctg gcc gag ttg 19221 Ala Ala Met Met Leu Ser Ala Glu Pro Glu Leu Thr Leu Ala Glu Leu 400 405 410 agg cag aga ctg atc cac ttc tct gcc aaa gat gtc atc aat gag gcc 19269 Arg Gln Arg Leu Ile His Phe Ser Ala Lys Asp Val Ile Asn Glu Ala 415 420 425 tgg ttc cct gag gac cag cgg gta ctg acc ccc aac ctg gtg gcc gcc 19317 Trp Phe Pro Glu Asp Gln Arg Val Leu Thr Pro Asn Leu Val Ala Ala 430 435 440 ctg ccc ccc agc acc cat ggg gca g gtaagcagga tggcagggtg 19362 Leu Pro Pro Ser Thr His Gly Ala 445 450 ggcaagtcca ggctggggct tgggaggtct gtgtgacctt gacagtctct cccttctccc 19422 ttgtctgtgt aaggaggatg atgccacctt aaataggatt aaatgagaat ggggctctga 19482 aagggctgtg caatattttc ataacgtgtt tttatagaga cagttgagta tgttctttaa 19542 gccctcctct ctcctaccat gaactaaaga tttttgtgga ggtcccctca ctcccagcac 19602 cccctcctca tcccaggccc tttttgca ggt tgg cag ctg ttt tgc agg act 19654 Gly Trp Gln Leu Phe Cys Arg Thr 455 gtg tgg tca gca cac tcg ggg cct aca cgg atg gcc aca gcc atc gcc 19702 Val Trp Ser Ala His Ser Gly Pro Thr Arg Met Ala Thr Ala Ile Ala 460 465 470 475 cgc tgc gcc cca gat gag gag ctg ctg agc tgc tcc agt ttc tcc agg 19750 Arg Cys Ala Pro Asp Glu Glu Leu Leu Ser Cys Ser Ser Phe Ser Arg 480 485 490 agt ggg aag cgg cgg ggc gag cgc atg gag gtgactgtac ccctccttcg 19800 Ser Gly Lys Arg Arg Gly Glu Arg Met Glu 495 500 tgtgtgtgtg tgtgtgtgtg tgtgtgtgtg tgcgtgtcag tgctgggccc tcagggaccc 19860 ccagcaagcc cctccatcct ccagactcca gctcttctgt aagcttacag ggctggccag 19920 accaggagtg gggcactcct cacttcacgc ggctgggggc tgctggagag agccacagcg 19980 ggaagggttt cctagaggct gcaggacagt gctggatgga ttttcaatgc tcacctgggt 20040 gtgagcatgc ggcagggccg cgtgagggtc agcgatctgc tactctggac tcagccatct 20100 ctaggcccct ctcactcagg tgctccatgg ttctgggagc tgagaaatct caaaccagca 20160 aaaaagtgga attgatgttg atgctacagg atagtgcaca gatgccatct ggttgcagca 20220 ttttggtgga agggcagtgc ccagctagga gagtgaggag gggcaggcat ttctggcttg 20280 aggagatagg gtcttaatgc tcgtgtgaga ggcagagtgg gtggagtgga gctggctgga 20340 tccttgcttt ggcctcctgg atttctctct atctccattt tgaaaccact ctgtgtttgg 20400 aagaactttt gagtattcag agctgcccac tggcagaaca gtcttccttg ggcaggagtg 20460 agctccttgt ccccagaagg ctgggtctgg ctggcccctg gcagggacac tgatgagggt 20520 gcttgagttg atcctgtcta gtccctttct gtgttttcaa agcccattct aaagcagatt 20580 cccatttccg tctttgactc taag gcc caa ggg ggc aag ctg gtc tgc cgg 20631 Ala Gln Gly Gly Lys Leu Val Cys Arg 505 510 gcc cac aac gct ttt ggg ggt gag ggt gtc tac gcc att gcc agg tgc 20679 Ala His Asn Ala Phe Gly Gly Glu Gly Val Tyr Ala Ile Ala Arg Cys 515 520 525 tgc ctg cta ccc cag gcc aac tgc agc gtc cac aca gct cca cca gct 20727 Cys Leu Leu Pro Gln Ala Asn Cys Ser Val His Thr Ala Pro Pro Ala 530 535 540 gag gcc agc atg ggg acc cgt gtc cac tgc cac caa cag ggc cac gtc 20775 Glu Ala Ser Met Gly Thr Arg Val His Cys His Gln Gln Gly His Val 545 550 555 ctc aca g gtaggaggct gggcttgccc tggggtgagg aggggtctct ttctccttat 20832 Leu Thr 560 gcacccactg cccacgaggc ttggtcctca caagtgtgat ccatgagact caagcctgac 20892 ttgcagttcc atactctggt tctgccactt ccatgccctt tgagcctggg caggtgacct 20952 tacttctcct catctcagct tcctcctcca taagagggaa aaaggtatta cctgcctcat 21012 tgtgttgcaa ggagatgggc agcatctagg gcactggcct ggagtatcgc aggtgctttg 21072 cctaaggtgg tgcagtccag gagaggcagc tccagagaga ggcccccggc tggggctgaa 21132 aggagggcag acctcggttt gaatttcacc ctgccgctcg atagctgtgt gacttgggca 21192 aattacttaa catctctgta tgaggaaatg atgagtgcta agcacttagc ttagtgccgg 21252 gacaatataa attctagcta tcgttactat tgttttcatc acccgttgct ttaaaatcca 21312 gtctctggta taggcaacta ttgacgggct accctgtgtc gaaaacatgc ccaggcaggt 21372 agcaggaagt cacagatggg gacctcttgg ggcatcaagg gatggtgccc tgaggctgag 21432 ctgttctggt tgggtggagc atgagaggtc tgggaagaca gtgggactcc agcctggaat 21492 aagaggctca gagttgattc tcgtctgagc acgtccaggg gaaccactga gggtttggga 21552 acaggagagt gagggtgaga acctggttct gggcacagca ggctggcatg taggatggat 21612 gttcaggaaa gatgagcata gtcaggtggc tggtgccctt gtccagggga gaggctccgt 21672 caggttcagg ggtcctggct tggagggaag tccgccatgc tctaatcacg ctcccctttg 21732 gaagtgctcg gccgatgagc tcacaggcac atgtcagttt gaagtcatgg aatctgactc 21792 catgaagcgc acctcaaaga gcaccatttt gcagctaagg gaactgcagg ctggacatgc 21852 tgagtggctg ccccgagccc ttgcagctag gacatagaga atgctagtaa ccacaaccct 21912 accatgttca gagcacatgc caggctccat gctggggctt cgcacgtgtc atcttcacag 21972 tgtccctgtg agtaggtgtg gtttctcttt ccatcttaca aatgagtaaa cagagcctca 22032 gtgtagctaa gtaaccacta ttttaggttt cttagccaat gggtgtgtct gactcctaag 22092 cccatggagg gcattctgag gtggttcaga cagaccccag cttacccttg aacttctgcc 22152 tgctggctgc atagggaggg gctgggggga gtttgagcat ctcaggccat agagcccctg 22212 cctcactgtc tccatctctg ggtggaaaga tggtgttttc cctgagaaac taaggctcag 22272 agaggttgaa tggctctccc aaggtcacac agctggtcag ctgcagagtt gagaacacag 22332 gagtcctggt gctcaggcca gcatctcttt ttttctttga gttgtttcta ggtttcctag 22392 ctcttgcctc agaccttaaa gagagagggt ctgatgggga tgggcactgg agacggagca 22452 tcccagcatt tcacatctga gctggctttc ctctgcccca ggc tgc agc tcc cac 22507 Gly Cys Ser Ser His 565 tgg gag gtg gag gac ctt ggc acc cac aag ccg cct gtg ctg agg cca 22555 Trp Glu Val Glu Asp Leu Gly Thr His Lys Pro Pro Val Leu Arg Pro 570 575 580 cga ggt cag ccc aac cag tgc gtg ggc cac agg gag gcc agc atc cac 22603 Arg Gly Gln Pro Asn Gln Cys Val Gly His Arg Glu Ala Ser Ile His 585 590 595 gct tcc tgc tgc cat gcc cca ggt ctg gaa tgc aaa gtc aag gag cat 22651 Ala Ser Cys Cys His Ala Pro Gly Leu Glu Cys Lys Val Lys Glu His 600 605 610 gga atc ccg gcc cct cag gag cag gtgaagaggc ccgtgaggcc gggtgggtgg 22705 Gly Ile Pro Ala Pro Gln Glu Gln 615 620 ggtgctgcgt gtctctcctg cacagctttt ctgtgtcagt ttgtgccacc accataccgc 22765 catacatcag ggtggcggtt tgccaggtag atgctgtggg cagcttccgc cattgtgtgg 22825 acagcatgta tatgtgtctc tgtgtggctg ggtctgtttt tgcttttgtc cagatcagta 22885 aggtttgcta cctgggtacc ccactccact tggagtagag tgtgcataaa tatggcataa 22945 agaaatgcaa tatgcatgca tttattgatt gatctatttt tttctgagat ggggtcttgc 23005 tgtgttgccc aggctggtct caaattcctg ggctcaagca atcctctggt ctcagcctcc 23065 ccaagtgttg ggattatagg catgagccgc tgcacctggc ctctctgatc tatttaacaa 23125 acctgctggg agggtctcag ggtcaggagc agcactgggc tctgaggaca cagagctcac 23185 tcagccgtga cccagagggg gtgcctgagc tgcatgctga aggttgttag catgaccagc 23245 aaggcaagaa aaggccctgc cgagattagc aaggcatgtg ccaagccctg gaatgtgaca 23305 gccgggcctt ctagaaacct gagtgtataa ctctccttaa aagccagtag gagctcctta 23365 aaaggcagcc ctaaggagtc cactcttaaa tgaactcaga gtcagtttta aaatgcaagt 23425 ctgtgttgat tctggtctgg atggtgcatt cctcgagagc aaaagacagt cttggtcttg 23485 gatccacttg ccctgggtac actgagggct gctaggttcc aggtgctctt cctggcactg 23545 gggagggata caggcccaag agacatgctg ttctccctcc tggagcatct attttagtgg 23605 aggaagacag aaaacaaacc attaatatag agtactgaaa agatgcgatg gagaaaacta 23665 tagcaaggaa gggaatgggg tgggagagag gtcaggagag gtctcgctga caaggtggac 23725 gaaacaggcc atgaggcaga gaacatgttc caggcaaagc aaaggccccc aggtggggat 23785 gtgcagggag taccaggaaa ccagagaggt gggaatagtt atgagatggg gggtgcctca 23845 gaggggacag ggccaagtca ggtgagacct gagggccaca gtcagcagtg agctggggcc 23905 atgcaggggt ctggcctcag aggagtgtgg tctggcctgg atctgaacct ctcactgtgg 23965 cctagctgct gagctgagaa gagatgacaa ggaccttggg cagaagcagg gagactggag 24025 ggaggcggtg gagggtccag gcgttggggc ggggctcagg ctggagtctg aagggagcct 24085 gcaggcctgg tgggtggatg tgggtgggag agggggagga tggcaccaag gctcgggccc 24145 ctggacagat ggagttgcca ttaagtggga tggggcaggc tatggggcca tcagtttcag 24205 agggatgagt ttggcactgg catggtaggc atctgtctat ctccacggcc ctcaaaccag 24265 gcatgaagca ggagctcacg tgtttggtca gccatggtgc agaaccgcct gggtgggagg 24325 tgcggggtgg gagatacacg gttgtgtccc aaatgggctc tgagccagcg agggccgtct 24385 gcactttggc ctcacagaag gatgtcggag ggagaaatga agtgtgggtg ggggtcccgg 24445 gccacgctag acatgtgctt tcttttcctc gggctctggc ag gtg acc gtg gcc 24499 Val Thr Val Ala 625 tgc gag gag ggc tgg acc ctg act ggc tgc agt gcc ctc cct ggg acc 24547 Cys Glu Glu Gly Trp Thr Leu Thr Gly Cys Ser Ala Leu Pro Gly Thr 630 635 640 tcc cac gtc ctg ggg gcc tac gcc gta gac aac acg tgt gta gtc agg 24595 Ser His Val Leu Gly Ala Tyr Ala Val Asp Asn Thr Cys Val Val Arg 645 650 655 agc cgg gac gtc agc act aca ggc agc acc agc gaa gag gcc gtg aca 24643 Ser Arg Asp Val Ser Thr Thr Gly Ser Thr Ser Glu Glu Ala Val Thr 660 665 670 gcc gtt gcc atc tgc tgc cgg agc cgg cac ctg gcg cag gcc tcc cag 24691 Ala Val Ala Ile Cys Cys Arg Ser Arg His Leu Ala Gln Ala Ser Gln 675 680 685 gag ctc cag tga cagccccatc ccaggatggg tgtctgggga gggtcaaggg 24743 Glu Leu Gln 690 ctggggctga gctttaaaat ggttccgact tgtccctctc tcagccctcc atggcctggc 24803 acgaggggat ggggatgctt ccgcctttcc ggggctgctg gcctggccct tgagtggggc 24863 agcctccttg cctggaactc actcactctg ggtgcctcct ccccaggtgg aggtgccagg 24923 aagctccctc cctcactgtg gggcatttca ccattcaaac aggtcgagct gtgctcgggt 24983 gctgccagct gctcccaatg tgccgatgtc cgtgggcaga atgactttta ttgagctctt 25043 gttccgtgcc aggcattcaa tcctcaggtc tccaccaagg aggcaggatt cttcccatgg 25103 ataggggagg gggcggtagg ggctgcaggg acaaacatcg ttggggggtg agtgtgaaag 25163 gtgctgatgg ccctcatctc cagctaactg tggagaagcc cctgggggct ccctgattaa 25223 tggaggctta gctttctgga tggcatctag ccagaggctg gagacaggtg tgcccctggt 25283 ggtcacaggc tgtgccttgg tttcctgagc cacctttact ctgctctatg ccaggctgtg 25343 ctagcaacac ccaaaggtgg cctgcgggga gccatcacct aggactgact cggcagtgtg 25403 cagtggtgca tgcactgtct cagccaaccc gctccactac ccggcagggt acacattcgc 25463 acccctactt cacagaggaa gaaacctgga accagagggg gcgtgcctgc caagctcaca 25523 cagcaggaac tgagccagaa acgcagattg ggctggctct gaagccaagc ctcttcttac 25583 ttcacccggc tgggctcctc atttttacgg gtaacagtga ggctgggaag gggaacacag 25643 accaggaagc tcggtgagtg atggcagaac gatgcctgca ggcatggaac tttttccgtt 25703 atcacccagg cctgattcac tggcctggcg gagatgcttc taaggcatgg tcgggggaga 25763 gggccaacaa ctgtccctcc ttgagcacca gccccaccca agcaagcaga catttatctt 25823 ttgggtctgt cctctctgtt gcctttttac agccaacttt tctagacctg ttttgctttt 25883 gtaacttgaa gatatttatt ctgggttttg tagcattttt attaatatgg tgacttttta 25943 aaataaaaac aaacaaacgt tgtcctaact cttgcataga cttgactgcc tagggtgatg 26003 ccttgcttat actaggaact gggtaagttt gttgaatagt tgagtaagcc aagtatttga 26063 tgagtacttg tatcttgagt acaagtattg ggcaagtact ggtgatgtga acttactcct 26123 tgtgcctatc ctaggaatga aatgaatgtc ttcctgcagc tcccctgacc accctgacag 26183 tcaaagtgcc tcctccttgg tgacaggtgc cctacag 26220 

What is claimed: 1- A method of detecting the presence of or predisposition to hypercholesterolemia, lipid and lipoprotein metabolism disorders, atherosclerosis, or cardiovascular diseases in a subject, the method comprising (i) providing a sample from the subject and (ii) detecting the presence of an alteration in the PCSK9 gene or in the NARC-1 polypeptide, said alteration in said gene or said polypeptide being indicative of the presence of or predisposition to hypercholesterolemia, lipid and lipoprotein metabolism disorders, atherosclerosis, or cardiovascular diseases. 2- The method according to claim 1, wherein said alteration reduces, modifies, or abolishes the activity of NARC-1. 3- The method according to claim 2, wherein said alteration is a substitution at nucleotide 625 and/or 890 of SEQ ID No
 1. 4- The method according to claim 2, wherein said alteration is selected from the group consisting of a T→A substitution at nucleotide 625 of SEQ ID No 1, a T→C substitution at nucleotide 890 of SEQ ID No 1 and a combination thereof. 5- The method according to claim 2, wherein said alteration is selected from the group consisting of a substitution of the residue Serine at position 127, a substitution of the residue Phenylalanine at position 216 and a combination thereof. 6- The method according to claim 2, wherein said alteration is selected from the group consisting of a substitution of the residue Serine at position 127 by an Arginine, a substitution of the residue Phenylalanine at position 216 by a Leucine and a combination thereof. 7- The method according to claim 1, wherein said hypercholesterolemia is autosomal dominant hypercholesterolemia. 8- A method of selecting biologically active compounds, said method comprising: a) contacting a test compound with an altered PCSK9 gene or an altered NARC-1 protein or fragment thereof of at least 15 consecutive residues comprising an alteration, wherein the alteration reduces, modifies, or abolishes the activity of NARC-1, and b) determining the ability of said test compound to modulate the expression and/or activity of said gene or protein or fragment. 9- An isolated or recombinant PCSK9 gene or a fragment thereof of at least 15 consecutive nucleotides comprising an alteration, wherein said alteration is a substitution at nucleotide 625 and/or 890 of SEQ ID No 1 or selected from the group consisting of the polymorphisms listed in Table 2 and in Table
 4. 10- The isolated or recombinant PCSK9 gene or the fragment thereof according to claim 9, wherein said alteration is selected from the group consisting of a T→A substitution at nucleotide 625 of SEQ ID No 1, a T→C substitution at nucleotide 890 of SEQ ID No 1 and a combination thereof. 11- The isolated or recombinant PCSK9 gene or the fragment thereof according to claim 9, wherein said alteration is selected from the group consisting of a substitution at nucleotides 476-478 of SEQ ID No 1, a substitution at nucleotides 482-484 of SEQ ID No 1, a substitution at nucleotides 488-490 of SEQ ID No 1, a substitution at nucleotides 485-490 of SEQ ID No 1, a substitution at nucleotides 548-553 of SEQ ID No 1, a substitution at nucleotides 479-481, 491-493 and 578-580 of SEQ ID No 1, a substitution at nucleotides 620-622 of SEQ ID No 1, a substitution at nucleotides 656-658 of SEQ ID No 1, a substitution at nucleotides 671-673 of SEQ ID No 1, a substitution at nucleotides 920-922 of SEQ ID No 1, and a substitution at nucleotides 1193-1195 of SEQ ID No
 1. 12- An isolated or purified NARC-1 protein or a fragment thereof of at least 8 consecutive amino acids comprising an alteration, wherein said alteration reduces, modifies, or abolishes the activity of NARC-1. 13- The isolated or purified NARC-1 protein or fragment thereof according to claim 12, wherein said alteration is selected from the group consisting of a substitution of the residue Tyrosine at position 78 of SEQ ID No 2 by an Alanine (Y78A), a substitution of the residue Valine at position 80 of SEQ ID No 2 by an Alanine or a Leucine (V80A or V80L), a substitution of the residue Leucine at position 82 of SEQ ID No 2 by an Alanine, a Valine or a Proline (L82A, L82V or L82P), a substitution of the residues Valine at positions 79, 80 and 81 of SEQ ID No 2 by an Arginine, an Arginine and a Leucine, respectively (V79R, V80R and V81L), a substitution of the residues Alanines at positions 102 and 103 of SEQ ID No 2 by Arginines (A102R and A103R), a substitution of the residues Valine at position 79, Lysine at position 83, and Leucine at position 112 of SEQ ID No 2 by an Isoleucine, a Methionine, a Proline, respectively (V79I, K83M and L112P), a substitution of the residue Methionine at position 126 of SEQ ID No 2 by an Alanine (M126A), a substitution of the residue Proline at position 138 of SEQ ID No 2 by a Tyrosine (P138Y), a substitution of the residue Isoleucine at position 143 of SEQ ID No 2 by a Proline (I143P), a substitution of the residue Histidine at position 226 of SEQ ID No 2 by an Alanine (H226A), and a substitution of the residue Asparagine at position 317 of SEQ ID No 2 by an Alanine (N317A). 14- An isolated or purified NARC-1 protein or a fragment thereof of at least 8 consecutive amino acids comprising an alteration, wherein said alteration is selected from the group consisting of an insertion of a residue Leucine at position 15 of SEQ ID No 2, a substitution of the residue Arginine at position 46 of SEQ ID No 2 by a Leucine, a substitution of the residue Alanine at position 53 of SEQ ID No 2 by a Valine, a substitution of the residue Serine at position 127 of SEQ ID No 2 by an Arginine, a substitution of the residue Phenylalanine at position 216 of SEQ ID No 2 by a Leucine, a substitution of the residue Isoleucine at position 474 of SEQ ID No 2 by a Valine, a substitution of the residue Glutamic acid at position 670 of SEQ ID No 2 by a Glycine and a combination thereof. 15- The isolated or purified NARC-1 protein or the fragment thereof according to claim 14, wherein said alteration is selected from the group consisting of a substitution of the residue Serine at position 127 by an Arginine, a substitution of the residue Phenylalanine at position 216 by a Leucine and a combination thereof. 16- The isolated or purified NARC-1 protein or the fragment thereof according to claim 12, wherein said alteration is located at one or several residues of the catalytic site of the NARC-1 protein or of a zymogen processing site of NARC-1. 17- A method of genotyping at least one polymorphism listed in Table 2 comprising (i) providing a sample from the subject and (ii) determining the identity of the allele of said polymorphism in said sample. 18- A diagnostic kit comprising primers, probes and/or antibodies for detecting in a sample from a subject the presence of an alteration in the PCSK9 gene or in the NARC-1 protein. 